Application: The Vulnerability Model - Huntington Meditation & Imagery Center

Date
First Name*
Last Name*
Address*
City*
State*
Zip*
Home Phone
Mobile Phone
Email*
How did you learn about this program?
Professional degree*
Do you have a current license or certification?*
- Yes
- No
State
Current place of employment
Please give us a brief description of the types of people you work with?*
What has interested you in attending this program?*
What are you hoping for in attending?*
Please tell us what your experience has been with imagery and meditation. What is your personal interest and your professional interest?*
Tuition for the course is $600 and can be paid via PayPal, by mail with a check, or in three installments on a payment plan. Select your preferred payment method below, and we'll follow up with you within 1-2 business days to arrange payment.*
- PayPal
- Check
- Payment Plan
We will contact you via email using the address you've provided.
Email
This field is for validation purposes and should be left unchanged.

Please be in touch with Richard at drrichardschaub@gmail.com for information on room and board costs and accommodation