Apply for RLT RI

Your RLT Certification Application

1Start

2Personal Details

3Professional Background

4Training Background

You’re applying for the RLT Certification

The application only takes five minutes to complete and helps us determine the most suitable Certification pathway for you. Once you submit your application, our team will review it and reach out to finalize your enrollment or ask any follow-up questions.

Your Name(Required)

First Name last Name

Phone(Required)

Email(Required)

County of Residence(Required)

Country

What is your professional background?(Required)

Therapist / Counselor / Psychologist

Social Worker / LMFT

Student in a health, counselling or coaching related field

Instructor in a health, counselling or coaching related field

Relationship Coach

Life Coach

Business or executive coach

Other Health professional

Other

Please tell us the institution you are enrolled in and the degree or certificate you are studying for:(Required)

E.g. Degrees, education, type of mental health profession...

(Expected) Date of graduation:(Required)

Month

Day

Year

Please describe your profession and how the RLT certification training will help you in your work:(Required)

How many years have you been working in that field?(Required)

An estimation is good enough!

With what regulatory body are you licensed?(Required)

Do you maintain professional liability insurance?(Required)

Yes

No

Are you currently working with couples?(Required)

Yes, couples work is my primary focus.

Yes, but it is not my primary focus.

No, I haven't worked with couples before.

No, but I have worked with couples in the past.

E.g. couples therapy, marriage counselling, couples coaching...

Have you done any trainings with Terry Real before?(Required)

Yes

No

For example: RLT Level 1, Terry's Couple Experiential Observation, The Relational Brain, Grandiose Women + Shut Down Men...

Please indicate all trainings that you have already taken.(Required)

I am already RLT certified (if this is the case, there no need to choose any of the courses below)

The Relational Life LEVEL 1 Training

The Relational Life LEVEL 2 Training

The Relational Life LEVEL 3 Training

The Relational Life Boot Camp/Essential Skills Workshop

(1) Observing Terry’s Couples Experiential Workshop

(2) Observing Terry’s Couples Experiential Workshop

Professional Teleclass or Webinar Series with Terry Real

24h of Real Life with Terry OR 24 hours of small group coaching from a Master Certified RLI coach

This is important to calculate your discount.

How familiar are you with Terry Real's work and RLT? (books, podcasts,events..)(Required)

books, podcasts, conferences..

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