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I-SOPA

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Thank you for your interest in joining the Indiana Somatically Oriented Practitioners Association!

If you feel that you meet the qualifications of one who is working somatically as a professional or one who is a current student of somatics (using the definition above of "somatics") and are interested to join I-SOPA, please fill out the short application below to help us get to know you better. Thank you!

I-SOPA Application

Your Personal Information

This information will not be publicly displayed; it is for the purposes of contacting you about your application and membership into I-SOPA.

First name*

Last name*

Email*

Phone*

Your Professional Work

Are you trained in and utilizing somatics in your work, a current student of somatics, or a professional who is interested in learning more about somatic approaches?*

Do you practice in or are you licensed in the state of Indiana?*

yes

Where is your practice located?*

What is the professional field in which you work? (check all that apply)*

Mental Health

Bodywork

Movement

Medicine

Other

What population of clientele do you currently work with?*

What, if any, somatically-oriented school or training programs have you completed or are in the process of completing?*

Please describe how you work somatically with your clients/students/etc.*

Please list your practice website or any bio pages where we could read more about you and your work. (Feel free to include more than one, if applicable.)*

Who referred you to this association?

Please provide the names and contact information of 1-3 professional colleagues or teachers/mentors who could serve as references for your work. (Please list their name, phone number, and email address.)*

What do you hope to gain by attending this group? (check all that apply)*

social networking/community

professional networking/referrals

professional development

other

***Please be aware that when you hit the submit button, it tends to jump back to the top of the form and clear your answers. However, unless you encounter red error messages indicating you did not complete a required field, we have received your submission and will be in touch. Thank you!***

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