The following two (three) certified Postural Integration Trainers acknowledge their observation of :

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
conducting a teaching lecture-demonstration of a model PI session, which included lecturing on the context, the stategy and the goals of the work in a particular phase of the PI process.

on. . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
          (date)                                                 (place )

before two PI trainers (the 'mentor trainer' and an outside trainer) and a group
of students.

We accept this lecture-demonstration as fulfilling part of the candidate's
requirements for becoming a PI Trainer.

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Trainer                                                     date

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Trainer                                                     date

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Trainer                                                    date
(optional)

A copy of this form to be presented together with your application and other
details required for the accessment of trainership to ICPIT.

PI Trainer Candidate Demonstration Form (2010)