Accreditation Application Form v1

Readiness Statement

Readiness Statement

Participants enter the Workshop aware that the group work training involves the development of new views and new actions with respect to their own professional and personal life and that this is likely to have a significant emotional impact. In the course of the explorations and expression, participants are always in charge of and responsible for the level of their interactions and self-disclosure. We advise participants who are undergoing significant personal stress to postpone attendance. Learning experiences can be intensive and unsettling emotional experiences. The act of enrolling in itself indicates an applicants understanding and acceptance that such explorations are part of the Workshop.

Personal Details

This information will be used to create your personal profile.

*Please confirm that your email address is entered correctly.
*Used to reset portal access if you lose login details or change jobs.
Materials for the program will be shipped to this address. If you are working from home please provide your home address.
Enter a language here if you speak a language other than English.

Registration Requirements

Requirements to register for the LSI Accreditation Program.

We recommend that LSI Accredited Practitioners have coaching experience, facilitation skills, and/or relevant professional qualifications before registering.

Please read through the Human Synergistics terms and conditions. Terms and Conditions - Online

Please read through the Human Synergistics Accreditation Deed. Accreditation Deed - Online

Account Details

Account Set-up. Provide details to create an account for your company.

Key Contacts. List the main contact for the account and a contact for accounts payable.

Invoicing and Insurance. Invoicing requirements and professional indemnity insurance.

Select Program


Cancellations or postponements will be accepted up to 7 weeks prior to program commencement at no charge.

Cancellations or postponements less than 7 weeks out but before 21 days from program commencement will incur a cancellation fee of 50% of workshop cost.

Cancellations or postponements 21 days or less from program commencement will incur the full workshop fee.

Request to split across two different workshops a fee of a 50% of the workshop cost is applicable.

Public programs are any programs that are available on our website.

Private inhouse programs are private groups that have been pre-arranged through your Account Manager.

Your LSI Client Details

Nominate the first person you will debrief using the LSI.

A nominated client is the first person you will debrief using the LSI. They will complete their own LSI 1 & 2 and their data is essential for you to be able to attend the Technical Workshop (Part 2). This first diagnostic is included in the cost of your Accreditation. WHO SHOULD I NOMINATE? Hand pick a nominated client who will support you through your development experience and who you already work with. This will be your first debrief, so choose someone who will assist your learning, doesn’t mind if you fumble your words and doesn’t mind if you don’t know all the answers.
It can be challenging to remain objective in a debrief if you are a respondent for the client or have a direct reporting relationship. Because of this we recommend you do not select someone you have a direct reporting relationship with.

Select someone who:
  • Is interested in their own development
  • Is comfortable to be open and honest with you in the debrief
  • You see regularly. There is pre-work which will involve you meeting with your client throughout the process.
  • You have an arm’s length relationship with – we’d recommend you don’t use a higher level manager, direct report or family member
If you don’t have someone at this time you can leave this section blank and provide us these details at a later date.

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