THE NEW ENGLAND SCHOOL OF BIOENERGETIC MEDICINE

818 Main Rd., Stamford, VT 05352. (802) 694-1994. info@newenglandschoolbem.org

APPLICATION FORM

Welcome to the New England School of Bioenergetic Medicine, where we don’t just provide an education—we ignite discovery, foster growth, and open doors to endless opportunities.

Discover what’s possible when you join a dynamic, supportive, and forward-thinking community.

PROGRAM OF INTEREST

Kindly select the program that interests you.

YOUR DETAILS

First name

Last name

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Birthday

Month

Day

Year

Biological Gender

Female

Male

Prefer not to say

EDUCATION

PROFESSIONAL LICENSES OR CERTIFICATIONS

PLEASE DESCRIBE ANY NEEDS OR SUPPORT TO ASSIST YOU WITH YOUR STUDIES.

No support needed.

FOUR-DAY INTENSIVE RESIDENTIAL STAY - DIETARY REQUIREMENTS: Please let us know if you have any dietary restrictions, such as a preference for vegan or vegetarian options or any food allergies.

No restrictions or allergies to foods.

PREVIOUS PARTICIPATION: If you’ve participated in a program, class, or event at the New England School of Bioenergetic Medicine or Stone Lions Farm, we’d love to hear which one.

PAYMENT OPTIONS

We are dedicated to providing excellent education at an affordable price. Please choose one of our flexible payment plans tailored to your budget, allowing you to choose the option that best suits your needs.

Discover more at: https://www.newenglandschoolbem.org/admissions

ACKNOWLEDGEMENT AND SIGNATURE

Your seat will be reserved once you submit a completed application, complete an interview with the Program Director, and pay the $100 application fee.

I hereby confirm that all information provided is accurate and complete. I understand that any false or misleading details may result in the rejection of my application.

Signature (kindly draw your signature below)

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