ALT rRgistration Form

ALT Application Form

3 September 2019 - 3 February 2020
For more information or questions on application process, financial support and coordination please contact our team.
Personal Information
Name *

First Name Last Name Preferred Nick Name

Current home address

Your position/ Current work
Organization
Phone Number

Area Code Phone Number
Personal e-mail *
example@example.com
Native language *
My command of English *

Excellent Good Fair
Obtaining a Visa *

Necessary Not necessary
NOTE: You will be responsible for obtaining an appropriate visa. ALT can help you with documentation. Please contact admin if you require more than 3 months visa
Do you have any medical issues (allergies, chronic disease, etc.)?
Do you have any dietary needs you would like to inform us about (e.g. vegetarian, diabetic, food allergies, etc.)?

Informative calculation of Tuition Fees *

MODULE 17: Mindful Facilitation for Empowerment (Gaia Education Training of Trainers) $ 1,200

MODULE 18: Community Organizing for Empowerment $ 500

MODULE 19: Mindful Activism $ 500

Applied Drama for Change $ 500

Planning and Facilitating Applied Drama $ 500

Enter coupon

Total $ 0.00

ALT is an non-profit organization. The module price is inclusive of food, accommodation and any travel made during the running of each module.

Those who pay full price will be automatically supporting those with financial need. A limited number of partial bursaries are available for participants in need.

If you register and pay for at least one dimension (4-5 modules), you are eligible for a 7% discount (enter coupon number 4MODULES+), and a 10% discount (equating to almost $1000) if registering and paying for the full course.
You Intend to *

Self-finance Raise funds for it Request ALT to help in finding funding support
Please tell us why you would like ALT to assist you in finding funding support? *
Please suggest the amount you are looking for, if you have opted for finding for funding support *
After submission of the application form, if successful, you will be required to transfer a minimum of $100 non-refundable deposit in order to confirm your place.

The process for payment will be as follows:

1. After the submission of this application form, you will receive a response within 7 days on decision of your application.

2. If successful, you will be requested to transfer a non-refundable deposit of $100, or the requested full amount in order to confirm your place.

3. Full payment must be received 15 days before the start of your chosen modules.

Help us get to know you better

Please answer the questions below.
Please tell us about your work.
Please tell us about your dream for yourself and your society/ community.
Please share with us why you would like to join this program. *
Please tell us about your spiritual training and practice.
How did you find out about this program? Did anyone recommend you to join? *
Is there anything else you would like to introduce yourself to us and other participants of this program?
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ALT Application Form