2015 AAP Conference Registration Form Page 1 of 12 CONFERENCE REGISTRATION FORM 2015 AAP Conference August 5-9, 2015 Be Your True Self: Discovering Inner Resources Association for the Advancement of Psychosynthesis Registration Notes: Conference Location: John Abbott College, 21,275 Lakeshore Road Sainte-Anne-de-Bellevue, Québec, H9X 3L9, Canada. Conference Begins Wednesday evening August 5, and ends mid-day Sunday August 9, 2015. General Conference Schedule: Arrival and Registration Wednesday August 5, 2-5 PM. Dinner: Wednesday August 5, 5:30 PM. Opening Remarks and Keynote Talk with Gianni Yoav Dattilo: Wednesday August 5, 7:00 PM Day 1 of Talks and Workshops: Thursday 9:00 AM – 5:30 PM Day 2 of Talks and Workshops: Friday 9:00 AM – 5:30 PM Day 3 of Talks and Workshops: Saturday 9:00 AM – 5:30 PM (There also may be programs after supper Thursday – Saturday) Day 4 of Talks and Workshops: Sunday 9:00 AM – 11:30 AM Conference Closing Ceremony: Sunday 12:00 PM Specific Talk and Workshop Schedules and registration for them are listed at the end of this form. Lodgings: College Dormitory Residences are available at additional fees (see below) or Off-Site Lodgings are also available. For Off-site lodgings: see http://www.hotels.com/de169716/hotels-montreal-quebec/ Transportation: Attendees must arrange their own transportation to and from the Conference Site. AAP will attempt to make arrangements for a shuttle bus to and from Pierre-Eliot Trudeau International Airport for certain hours on Wednesday and Sunday, however this is subject to confirmation in July. For information about shuttles to and from the airport, contact the Conference Chair at conference@aap-psychosynthesis.org Meals with Registration: Full Conference Registration includes meals and snacks. Handicap Accessible: Please alert the Registrar of any Special Needs. Trainer Summit on Wednesday, August 5, 2015 (All day pre-conference event): This is an event for Psychosynthesis Trainers only; contact Brad Roth at dancingday@earthlink.net for an invitation to attend. CE Credits: AAP has been approved by National Board of Certified Counselors (NBCC) as an Approved Continuing Education Provider, ACEP No. 6403. Programs that do not qualify for 2015 AAP Conference Registration Form Page 2 of 12 NBCC credit are clearly identified. AAP is solely responsible for all aspects of the programs. You MUST check off the box in the registration form and pay the processing fee below if you desire to receive CE credits. Financial Aid: A limited number of work-study and need-based scholarships are available for those who need help to offset registration fees. Scholarships will offset part of the conference fees. To request a scholarship application, please contact the Conference Chair at conference@aap-psychosynthesis.org. All completed financial aid applications must be received by June 1, 2015 and will be held in confidence. Scholarship applicants will be notified of decision by July 1, 2015. Cancellation/Refund Policy: Requests for refunds MUST be made in writing to: AAP Conference Refund 61 East Main Street Cheshire, MA 01225-9627, USA Please provide your name, address, the date and amount of your payment. A Full refund, minus a $50 service charge, will be made for requests received (not postmarked) before July 31, 2015. No refunds will be made thereafter. Complaint Policy: Complaints or comments concerning any aspect of this Conference must be made in writing to: AAP Conference Chair 61 East Main Street Cheshire, MA 01225-9627, USA Please provide your name, address, the date and names of the events you have attended and your specific request or complaint. Any submittals will be referred to AAP’s governing body, The Steering Committee, for a formal response. Languages: Most of the conference will be conducted in English. Some talks and workshops may be presented French. The conference cannot provide translation services, as AAP unfortunately cannot afford the costs of translation and interpretation NOTE: Registrations received after July 31, 2015 are subject to availability. We urge all attendees to register before July 31 due to restrictions at the College and the Food Services. Start the Registration Form on the Next Page: 2015 AAP Conference Registration Form Page 3 of 12 Directions: This document is a fill-in electronic form. Use your cursor to move forward to the next field, save the file, and email this registration form as an attachment to the Conference Registrar at Registrar@aap-psychosynthesis.org or mail the printed form to: AAP Conference Registration, 61 East Main Street, Cheshire, MA 01225-9627 USA. All checks should be mailed to the above address. For questions about registration, call Conference Registrar Audrey McMorrow at (401) 864-3707: PERSONAL INFORMATION : a. b. c. d. NAME: Degree or Suffix, if desired: STREET ADDRESS: CITY STATE/COUNTRY ZIP/POSTAL CODE PHONE: CELL: FAX: EMAIL ADDRESS: REGISTRATION OPTIONS: (Please check all that apply) Note: Conference fee includes meals but not lodging (Full Conference fee for non-members includes AAP membership for the balance of 2015) *American Residents must pay in US Dollars. *Canadian Residents may pay in Canadian Dollars. ALL others must may in US Dollars. FULL CONFERENCE (AAP Member) Before May 15 $375 Before June 30 $400 On or After July 1 $450 FULL CONFERENCE (Non Member) Before May 15 $425 Before June 30 $450 On or After July 1 $500 ONE DAY ONLY (AAP Member) Before May 15 $125 Before June 30 $135 On or After July 1 $150 Before May 15 $140 Before June 30 $150 On or After July 1 $165 Aug.6 Aug.7 Aug.8 ONE DAY ONLY (Non Member) Aug.6 Aug.7 Aug.8 Trainer Summit Program August 5 (for Psychosynthesis Trainers and by Reservation Only – contact Brad Roth at dancingday@earthlink.net for a Reservation Confirmation) CE Credits Processing Fee (AAP is an ACEP for NBCC and CA.BBS) A Certificate of CE credit will be mailed after the conference. Amount Due $* $30 $30 LODGING: John Abbott College has residential dormitory suites available for AAP Conference use. Each suite has either one bedroom (two beds) or two bedrooms (four beds) with living 2015 AAP Conference Registration Form Page 4 of 12 area and efficiency kitchen area. Some local people may provide lodging arrangements, and if you will volunteers to provide local lodging for attendees, please contact the Conference Registrar at Registrar@aap-psychosynthesis.org. If you wish to obtain local lodging with a volunteer, please contact the Conference Registrar to check on availability. Hotel accommodations are also available—check the AAP website or http://www.hotels.com/de169716/hotels-montreal-quebec/. AAP makes every effort to accommodate peoples’ preferences, but we cannot guarantee anything in advance. Please Note: When all John Abbott College rooms are booked, there will be overflow accommodations are available at Laird Hall of MacDonald College (same campus) about a oneminute walk away. Laird Hall offers one person and two-person rooms, with common washrooms segregated by gender. If you wish to be considered for overflow accommodations, in case the John Abbott College rooms are all booked at the time you register, please fill in both sections 1 & 2 below. 1. John Abbott College dormitory I wish to stay at a John Abbott College dormitory room at $35.00 (US dollars) per night For One night Two nights Three nights Four nights Five nights I prefer: Two-person Suite Four-person Suite 2. Laird Hall dormitory If all John Abbott College dormitory rooms are taken, then I wish to stay at Laird Hall at $35.00 per night: Yes No — I wish to stay at a Laird Hall dormitory room at $35.00 (US dollars) per night For One night Two nights Three nights Four nights Five nights I prefer: One-person Room Two-person Room I have Handicap or Special Needs as Follows: I Need Assistance at the Conference as Follows: I prefer: Two-person Suite Special Lodging Requests: Preferred Room-mate(s) if possible: My gender: Male Female Preferred Room-mate(s): Male Four-person Suite Female Either Male or Female I will make other lodging arrangements Cost of Lodging at $35.00 per night: $ * 2015 AAP Conference Registration Form Page 5 of 12 Subtotal: Add Conference Fee, Trainer Summit (if applicable), CE Credits Processing Fee (if applicable), and Cost of Lodging (if applicable): $ * DISCOUNTS and SCHOLARSHIPS: Discount for Speakers and Workshop Presenters: $75.00 -$ Student Scholarship: (Amount Approved by Conference Chair) -$ Work-Study Scholarship (Amount Approved by Conference Chair) -$ Financial Need Scholarship (Amount Approved by Conference Chair) -$ Total Discount and Scholarship Amount to be deducted from conference fee: -$ * Please deduct the Total Discounts from your Subtotal above to arrive at your total fee: Please verify this amount with the Conference Registrar before proceeding to payment. PAYMENT INFORMATION: Note: All conference and college dormitory lodging fees listed include Québec provincial Goods and Services Tax, and Canadian national Sales Tax (14.875%). *American Residents must pay in US Dollars. *Canadian Residents may pay in Canadian Dollars. ALL others must may in US Dollars. Deduct Total Discounts from Subtotal Above: PAYMENT INFORMATION: TOTAL DUE: $ * My Check in U.S. or Canadian currency payable to AAP is enclosed in the amount of $ * PayPal (U.S. or Canadian Currency only) $ * MEALS: The cost of the following meals at the dining hall of John Abbott College are included in the conference cost: Dinner Wednesday August 5; Breakfast, lunch and dinner Thursday, Friday and Saturday, August 6-8, and breakfast Sunday August 9. Light snacks for the mornings and afternoons of August 6-8 are also included. For the Trainer Summit, Breakfast and Lunch on Wednesday August 5 are included. Please check your preferences: Ordinary Diet: Vegetarian Only Meat Poultry Vegan Only Fish Either 2015 AAP Conference Registration Form Page 6 of 12 Please send my registration confirmation by: email U.S. Mail Please add any notes and concerns for the registrar here: On Line Registration at www.aap-psychosynthesis.org Following is a complete Conference Schedule. At the end of this document you will find check boxes from which to choose your talk and workshop selections. 2015 AAP Conference Program NBCC CE Credit Hours are indicated after each presentation. “NCE” indicated no NBCC credit hours awarded. Wednesday August 5, 2015 Dinner: 5:30 – 7:00 PM 7:00 – 7:30 PM: Opening Words Self: A City With Many Gates and announcements, with Jan Kuniholm, AAP Conference Chair 7:30 – 9:00 PM: Keynote Talk: The Ubiquity of Self with Dr. Gianni Yoav Dattilo, PhD, former President of the Italian Society of Psychosynthesis Psychotherapists (CE-1.50) Thursday August 6, 2015 Announcements 8:45 a.m. Jan Kuniholm, AAP Conference Chair Plenary Talk A (9:00 a.m. – 10:00 p.m.) Psychosynthesis and Healing: Exploring Illness and Wholeness with Dorothy Firman, EdD (CE-1.00) Workshop 102 (10:00 a.m. – 1:00 p.m.) La maladie: un chemin vers le SOI [Illness: a Path to Self](présentée en français) avec Hélène-Françoise Lizotte (NCE) (translator will attend) 2015 AAP Conference Registration Form Page 7 of 12 Workshop 104 (10:00 a.m. – 1:00 p.m.) LUNCH Inner and Outer Peace - Embracing Unity: Archetypal Psychosynthesis with Kristina Brode, PhD (CE-3.00) (1:00 p.m. – 2:30 p.m.) Workshop 105 (2:30 p.m. – 5:30 p.m.) Living with Joy Beyond… with Denise Boivin, BA (NCE) Workshop 106 (2:30 p.m. – 5:30 p.m.) Soul Process Work with Thomas Yeomans, PhD (CE-3.00) Workshop 107 (2:30 p.m. – 5:30 p.m.) Giving Voice to Our Inner Self with Chiara Claudi, MA (NCE) Workshop 108 (2:30 p.m. – 5:30 p.m.) Helping Professionals Tap into Children’s Intuitive Wisdom and Their Own with Ilene Val-Essen, PhD (CE-3.00) Dinner: (5:30 – 7:00 PM) Plenary Talk B ( 7:00 p.m. – 9:00 p.m.) Being Your Self at Home and the Presence of Longing with Massimo Rosselli, M.D. of the Italian Society of Psychosynthesis Psychotherapists (CE-2.00) Friday August 7, 2015 Announcements 8:45 a.m. Jan Kuniholm, AAP Conference Chair Plenary Talk C ( 9:00 a.m. – 10:00 a.m.) Losing and Re-finding Self/self in Human Systems with Mark Horowitz, MA (CE-1.00) Workshop 201(10:00 a.m. – 11:30 p.m.) EmBODYing the Self with Janet Messer, PhD (CE-2.00) Workshop 202(10:00 a.m. – 11:30 p.m.) Pratiques psycho-corporelles anthropologiques en Psychosynthese (présentée en français) avec Joël Niemann, Dip. Univ. of Bordeaux (CE-2.00) (translator will attend) Workshop 203(10:00 a.m. – 11:30 p.m.) Goodness of Fit: Psychosynthesis Coaching as a Path to Right Livelihood with Dorothy Firman, EdD (CE-1.50) Workshop 204(10:00 a.m. – 11:30 p.m.) Hemispheric Synchronization with Michael Brown, EdS (CE-2.00) 2015 AAP Conference Registration Form Page 8 of 12 Plenary Meeting (11:45 a.m. – 1:00 p.m.) LUNCH AAP Annual Meeting All Conference Attendees are invited to help AAP plan for the future. (1:00 p.m. – 2:30 p.m.) Workshop 205A(2:30 p.m. – 4:00 p.m.) Seeing Others and Being Yourself: The Lifelong Practice of Balancing Love and Power in Relationships with Mark Horowitz, MA (CE-1.50) Workshop 205B(4:00 p.m. – 5:30 p.m.) A Psychosynthesis 12 Step Process for Transforming Consciousness with Michael Brown, EdS (CE-1.50) Workshop 206 (2:30 p.m. – 5:30 p.m.) New Arenas for Psychosynthesis: Group Work in Business Organizations with Elizabeth Sudler, MSW (CE-3.00) Workshop 208A(2:30 p.m. – 4:00 p.m.) Assagioli's Gifts: Symbols and Techniques for Personal Transformation with Jon Schottland, MA (CE-1.50) Talk 208B The Psychology of Organizations: Methodology with Robert Caveney (NCE) Dinner: (4:00p.m. – 5:30 p.m.) (5:30 – 7:00 PM) Psychosynthesis Group Activities (7:00 p.m. – 9.00 p.m.) Deepening the Process: Explore SELF with Others in Small Groups — All Conference Attendees are Invited to Explore Self in Small Groups in a Relaxed Atmosphere Saturday August 8, 2015 Announcements 8:45 a.m. Jan Kuniholm, AAP Conference Chair Plenary Talk D (9:00 a.m. – 10:00 a.m.) Reducing Suffering: The Clinical Applications of Psychosynthesis with Richard Schaub, PhD (CE-1.00) Workshop 301 (10:00 a.m. – 1:00 p.m.) Selfless Self - The Journey Toward Wholeness with Dirk Kelder, MDiv (CE-3.00) Workshop 302A(10:00 a.m. – 11:30 p.m.) Liberating Young Adults from Negative SelfImages: Disidentification and SelfRealization Methods with Richard Schaub, PhD, and Bonney Gulino Schaub, MS (CE-1.50) 2015 AAP Conference Registration Form Page 9 of 12 Workshop 302B(11:30 p.m. – 1:00 p.m.) Psychosynthesis Methods for Working with Trauma: Accessing Inner Wisdom with Victoria Gulino, MSEd (CE-1.50) Workshop 303 (10:00 a.m. – 1:00 p.m.) The Call of Self with Phyllis Clay, PhD (CE-3.00) Workshop 304 (10:00 a.m. – 1:00 p.m.) Honouring the Sacred Feminine Within Us and All Planetary Life with Sandy Greer, PhD (CE-3.00) LUNCH (1:00 p.m. – 2:30 p.m.) Workshop 305 (2:30 p.m. – 5:30 p.m.) Embodying the Rights of the Soul for Your Self to be Here with Massimo Rosselli, MD (CE-3.00) Workshop 307 (2:30 p.m. – 5:30 p.m.) Art as a Healing Tool for Self and Earth:Tapping into Nature’s Archetypical Well for Inspiration & Life Purpose With Alan Steinberg, BA (NCE) Workshop 308 (2:30 p.m. – 5:30 p.m.) Pragmatic Mindfulness: Redesigning Your Daily Conflict Patterns with Walter Polt, MA, and Cynthia Lashley, PhD (CE-3.00) Dinner: (5:30 – 7:00 PM) Psychosynthesis Group Activities (7:00 p.m. – 9.00 p.m.) Deepening the Process: Explore SELF with Others in Small Groups — All Conference Attendees are Invited to Explore Self in Small Groups in a Relaxed Atmosphere Sunday August 9, 2015 Announcements 8:45 a.m. Jan Kuniholm, AAP Conference Chair Plenary Talk E ( 9:00 a.m. – 10:00 a.m.) The Third Awakening with Thomas Yeomans, PhD (CE-1.00) Workshop 401 (10:00 a.m. – 11:30 a.m.) “Confidence in your Self, Not in Your Personality” (Roberto Assagioli) with Anne Yeomans, MA (CE-1.50) Workshop 403 (10:00 a.m. – 11:30 p.m.) The "Art" of Self Discovery with Audrey McMorrow, MA, CAGS, and Bodhi Simpson, MS (CE-2.00) 2015 AAP Conference Registration Form Page 10 of 12 Conference Closing Ceremony 12:00 p.m. Go to 2015 AAP Conference Program with Check Boxes for Registration on Next Page. 2015 AAP Conference Registration Form Page 11 of 12 2015 AAP Conference Program with Check Boxes for Registration Please review the Conference Program for exact conference talk and workshop titles, descriptions, presenters’ names and credentials, learning objectives and continuing education credits, and times. Detailed workshop descriptions are given at http://aappsychosynthesis.org/2015-conference-schedule/ and specific workshop details can be accessed from that web page, for each dat. Please check off ALL talks and workshops you plan to attend. Wednesday August 5, 2015 Dinner: 5:00 – 7:00 PM 7:00 – 7:30 PM: Opening Words Self: A City With Many Gates and announcements, by Jan Kuniholm, AAP Conference Chair 7:30-9:00 PM: KeyNote Talk: ☐ The Ubiquity of Self with Dr. Gianni Yoav Dattilo, President of the Italian Society of Psychosynthesis Psychotherapists Thursday August 6, 2015 Plenary Talk A Dorothy Firman Morning Workshops Afternoon Workshops Plenary Talk B ( 9:00 a.m. – 10:00 a.m.) ☐ Psychosynthesis and Healing with ( 10:00 a.m. – 1:00 p.m.) ( 2:30 p.m. – 5:30 p.m.) ( 7:00 p.m. – 9:00 p.m. ☐102 ☐104 ☐105 ☐106 ☐107 ☐108 ☐ Being Your Self at Home and The Presence of Longing with Massimo Rosselli Friday August 7, 2015 Plenary Talk C ( 9:00 a.m. – 10:00 a.m.) Morning Workshops ( 10:00 a.m. – 11:30 p.m.) ☐ Losing and Re-finding Self/self in Human Systems with Mark Horowitz ☐201 ☐202 ☐203 ☐204 AAP ANNUAL MEETING (11:45 a.m. - 1:00 p.m.) All Attendees are invited to attend Afternoon Workshops ( 2:30 p.m. – 4:00 p.m.) Afternoon Workshops ( 4:00 p.m. – 5:30 p.m.) Afternoon Workshops ( 2:30 p.m. – 5:30 p.m.) ☐205A ☐205B ☐206 ☐208A ☐208B Saturday August 8, 2015 Plenary Talk D ( 9:00 a.m. – 10:00 a.m.) Morning Workshops ( 10:00 a.m. – 1:00 p.m.) ☐ Reducing Suffering with Richard Schaub ☐301 ☐303 ☐304 2015 AAP Conference Registration Form Page 12 of 12 Morning Workshops ( 10:00 a.m. – 11:30 a.m.) Morning Workshops ( 11:30 a.m. – 1:00 p.m.) Afternoon Workshops ( 2:30 p.m. – 5:30 p.m.) ☐302A ☐302B ☐305 ☐307 ☐308 Sunday August 9, 2015 Plenary Talk A ( 9:00 a.m. – 10:00 a.m.) Morning Workshops ( 10:00 a.m. – 11:30 p.m.) ☐ The Third Awakening with Thomas Yeomans ☐401 ☐403 CONFERENCE CLOSING CEREMONY 12:00 p.m. All Attendees are invited to attend