PAIRS Level I Facilitator Application Dear Prospective PAIRS Facilitator Candidate,

Thank you for your interest in pursuing a license as a PAIRS Level I Facilitator to make the PAIRS Essentials curriculum and associated curricula available to your organization, community or clients through your services as a PAIRS Facilitator.

Attached, you will find a complete set of application materials. Part I of the application should be completed within the next 30 days. After Part I has been accepted by PAIRS, Part II will be requested. Following approval of Part II, you will be provided access to our on-line learning course and offered dates for the in-person training. You are strongly encouraged to bring a partner, family member or close friend to the in-person training. Because of the importance of participating with a partner, there is no additional charge for their tuition.

Briefly, you will need to provide the following for Part I:

1. The application form itself, attached with either your resume/CV or completed sections below.

2. The essay responding to the questions in the application.

3. Your self-assessment of the characteristics of a PAIRS instructor.

4. Acceptance of the PAIRS Ethics Agreement and Licensing Agreement.

5. Your first PAIRS Essentials class preparations.

Upon approval of part I, Part II will be requested and includes:

1. Three references that can comment on your ability to effectively present.

2. Permission for Purpose Built Family Foundation (PAIRS) to perform a background check.

3. Your payment of any balance due for annual license fee, refundable if you are not approved.

To be considered for this appointment, please ensure all required materials for Part I are provided to our Training Director by mail or email within 30 days of this letter:

Training Director

Purpose Built Families Foundation9050 Pines Blvd., Suite 305, Pembroke Pines, FL 33024

info@pairs.com | (888) PAIRS-4U

We will review and respond to your request within 30 days of receipt of all requested information.

Sincerely,

Seth Eisenberg, CEO Purpose Built Families Foundation(888) 724-7748 x810

PAIRS LEVEL 1 FACILITATOR APPLICATION OVERVIEW

Becoming a PAIRS Facilitator certified to provide services to your community or organization audiences is an intensive, multi-step process involving self-discovery, transparent and vulnerable self-disclosure, cultivation, exploration and utilization of empathy for self and other, an invitation to deep personal growth, an openness to critique from class participants, master trainers, and fellow trainees, and a commitment to using the self in compassionate connection to others to build a safer, saner, more loving world.

This process is not a solo journey of mastering the memorization of specific presentation content nor is it based on any particular religious dogma, though full knowledge of the material and a respect for the sacred is essential. Rather, the process requires a deep development of the human capacity to see the self and the other through sacred, loving eyes, and the capacity to make meaningful connections, with the expectation that such connections will lead to the healing of the self and the other, increasing the well-being of both as one step toward healthy community.

Central to this process is a commitment to practice and mentor others in excellence in communication, emotional literacy, and conflict resolution skill development. That commitment requires continued learning and continuous improvement, i.e., that becoming a certified Facilitator, while a significant accomplishment to be celebrated and applauded, is not the end of a learning commitment but rather a step forward in an ongoing process of learning in order to provide leadership on behalf of PAIRS Foundation’s longstanding vision for a safer, saner, more loving world.

The application process consists of submitting contact information, academic and certification/training history, leadership positions, honors, publications, an essay, a self rating on facilitator qualities, three letters of recommendation and rating forms from persons you choose, and acceptance of the terms of the PAIRS Code of Ethics and Licensing Standards.

Should you be approved for training and successfully complete the in person and online training requirements you will be licensed on an ongoing yearly basis. You may conduct as many classes as you wish and the business model you choose to use to facilitate your work is up to you, within the guidelines of the Licensing and Ethical Standards. We will help you design your business plan during your training.

PAIRS LEVEL 1 FACILITATOR APPLICATION OVERVIEW

For the in-person PAIRS Essentials experience component of the training, you are required to bring a partner. PAIRS is a relationship skills program and in order for you to effectively teach the program, we want you to experience the tools at a deep, meaningful level that can only be achieved with a partner with whom you have a relationship. The partner can be a spouse, significant other, family member or friend. Your PAIRS Level 1 Training partner may be added on to your license as a sub-licensee who can co-facilitate PAIRS classes with you. They will need to complete their own version of this application, as well as all required online and in person training in order to be approved as your co-facilitator. You may add any trained PAIRS Facilitator to your license for joint work as a Facilitator Team. Please notify PAIRS when you have another fully qualified Facilitator working under your license. We strongly encourage you to be actively planning your first class prior to the start date of your training. Focusing on your possible attendees, scheduling details, and booking venue logistics will sharpen your focus and help you achieve your goals for contribution and impact. For example:

• You are a member of an organization requesting you to conduct PAIRS Essentials on their behalf or you have the interest of at least 10 persons to participate in your class.

• You have a commitment with another licensed co-facilitator to conduct the class with you.

• You have explored possible venues.

Please reach out to us with any questions. We are available to provide support through your entire PAIRS experience!

SECTION ONE: PERSONAL INFORMATION

First Name Middle Last Name

Org. Affiliation Title

Mailing Address

City State Zip Code

Home Phone Cell Phone

Work Phone Fax Number

Work EmailPersonal Email

Marital Status

Name of Spouse, Domestic Partner, Significant Other

SECTION TWO: HIGHER EDUCATION

Please list below your higher education or provide your resume/CV.

Date Institution City, State Degree GPAAdditional

Concentration

SECTION THREE: SPECIALIZED TRAINING/CERTIFICATIONS

Please list below any specialized training or certifications you have received or provide your resume/CV.

DateSponsoring

AgencyCity, State Certification/Training

SECTION FOUR: EMPLOYMENT HISTORY

Please list your work history over the past 15 years, or provide your resume/CV.

Dates Position Organization/Company City, State

SECTION FIVE: LEADERSHIP AND RECOGNITION

Please list leadership positions, honors and exceptional recognitions, or provide your resume/CV.

Dates PositionOrganization/

CompanyCity, State

SECTION SIX: PUBLICATIONS

Please list your publication history, if applicable, over the past 15 years, or provide your resume/CV.

SECTION SEVEN: VOLUNTEER OR OTHER SERVICES TO COMMUNITY

Dates Agency Position Services Provided

Date Title Publication Role

SECTION EIGHT: SELF-EVALUATION OF QUALITIES OF EFFECTIVE PAIRS FACILITATORS

Overall, the PAIRS Facilitator should be personable, have life experience, and be trustworthy, responsible, and caring. An effective facilitator should be someone who does not read the material off the printed page or PowerPoint in class; a person who has a sense of humor, healthy self-esteem, charisma, energy, enthusiasm, and life wisdom. The qualities listed below have been found to be common characteristics of effective PAIRS facilitators. Please rate yourself in each category as follows:

Rating Quality Rating Quality

Personal warmth Optimistic

Authenticity Poised

MaturitySpeaks clearly with appropriate pacing and expression, and is easily understood

Emotionally stable and comfortable with emotional intensity

Appropriate professional appearance and grooming

Relevant and appropriate self-disclosure Avoids wordiness, professional jargon terminology

Ability to maintain a safe educationalenvironment, including appropriate boundaries

Use of appropriate humor

At ease with groups Works cooperatively with staff and team members

Knowledge of the curriculum and its intended purpose

Avoids inappropriate comments or offensive behavior

Stays within boundaries and topics of each class Provides clear and accurate direction

Covers all required material and exercises within time allowed

Effectively teaches existing curriculum content as it is written

Appropriately evaluates and reads participant responses

Does not add curriculum material without prior approval from PAIRS Foundation

Handles transitions effectively Establishes group rapport

Consistently receives positive evaluations from class participants

Fully prepared for each class with clear, organized presentations

Identifies and recommends improvements based on group feedback

Understands and respects the vulnerabilities of class participants

1 = needs improvement; 2 = adequate; 3 = above average; 4 = superior.

SECTION NINE: PERSONAL STATEMENT

Please provide a statement of 2 to 3 pages, addressing the following questions:

1. What motivates you at this time to seek certification as a PAIRS Facilitator?

2. What have been the major events and people that have shaped your life?

3. What have been the major learnings you have gained from engaging those people and events?

4. What do you consider to be your vulnerabilities including emotional allergies?

5. What are your key areas for personal growth?

6. How would you apply your life story to your teaching of PAIRS?

SECTION NINE: PERSONAL STATEMENT (Cont.)

SECTION NINE: PERSONAL STATEMENT (Cont.)

SECTION TEN: YOUR FIRST CLASS PLANNING

Please provide a statement addressing the following questions:

1. Who are your most likely participants you can enroll for your class?

2. What support do you have in your organization or community for teaching PAIRS classes?

3. What venues are available to you for a class of 10 -20 persons? Cost?

4. What do you want to better understand about the logistics and process of organizing a class?

5. What excites you about the prospects of teaching a PAIRS class?

SECTION ELEVEN: REFERENCES

Please list three people, preferably those who have seen you present working with groups, with teams, or in an educational setting, who will provide a reference and letter of recommendation:

REFERENCE #1

Name Email Address Phone Position

Years Known Place of Work

Title

REFERENCE #2

Name Email Address Phone Position

Years Known Place of Work

Title

REFERENCE #3

Name Email Address Phone Position

Years Known Place of Work

Title

NAME OF APPLICANT:

I have asked you to submit a letter of reference and recommendation for my application to be a candidate as a PAIRS Facilitator. Overall, the PAIRS Facilitator should be personable, have life experience, and be trustworthy, responsible, and caring. An effective facilitator should be someone who does not read the material off the printed page or PowerPoint in class; a person who has a sense of humor, healthy self-esteem, charisma, energy, enthusiasm, and life wisdom. These qualities may help you in considering what you have observed of me. Please be direct and as objective as possible in your assessment as we all have strengths and opportunities for growth. Your honest feedback is essential for my education as a facilitator. The qualities listed below have been found to be some of the most important characteristics of effective PAIRS Facilitators. Please rate me on the following scale:

1 = needs improvement; 2 = adequate; 3 = above average; 4 = superior; N/A = unknown

Rating Quality Rating Quality

Personal warmth Optimistic

Authenticity Poised

Maturity Use of appropriate humor

Emotionally stable and comfortable with emotional intensity

Appropriate professional appearance and grooming

Relevant and appropriate self-disclosure Avoids wordiness, professional jargon terminology

Ability to maintain a safe educationalenvironment, including appropriateboundaries

Speaks clearly with appropriatepacing and expression, and is easilyunderstood

At ease with groups Works cooperatively with staff and team members

Knowledge of the curriculum and itsintended purpose

Avoids inappropriate comments or offensive behavior

Stays within boundaries and topics ofeach class Provides clear and accurate direction

Covers all required material and exerciseswithin time allowed

Effectively teaches existing curriculumcontent as it is written

Appropriately evaluates and readsparticipant responses

Does not add curriculum materialwithout prior approval from PAIRSFoundation

Handles transitions effectively Understands and respects thevulnerabilities of class participants

Consistently receives positive evaluationsfrom class participants

Fully prepared for each class with clear, organized presentations

Identifies and recommendsimprovements based on group feedback Establishes group rapport

Return this form and your letter of recommendation to: Training Director, Purpose Built Families Foundation,

9050 Pines Blvd., Suite 305, Pembroke Pines, FL 33024

NAME OF APPLICANT:

I have asked you to submit a letter of reference and recommendation for my application to be a candidate as a PAIRS Facilitator. Overall, the PAIRS Facilitator should be personable, have life experience, and be trustworthy, responsible, and caring. An effective facilitator should be someone who does not read the material off the printed page or PowerPoint in class; a person who has a sense of humor, healthy self-esteem, charisma, energy, enthusiasm, and life wisdom. These qualities may help you in considering what you have observed of me. Please be direct and as objective as possible in your assessment as we all have strengths and opportunities for growth. Your honest feedback is essential for my education as a facilitator. The qualities listed below have been found to be some of the most important characteristics of effective PAIRS Facilitators. Please rate me on the following scale:

1 = needs improvement; 2 = adequate; 3 = above average; 4 = superior; N/A = unknown

Rating Quality Rating Quality

Personal warmth Optimistic

Authenticity Poised

Maturity At ease with groups

Emotionally stable and comfortable with emotional intensity

Appropriate professional appearance and grooming

Relevant and appropriate self-disclosure Avoids wordiness, professional jargon terminology

Ability to maintain a safe educationalenvironment, including appropriate boundaries

Use of appropriate humor

Speaks clearly with appropriate pacing and expression, and is easily understood

Works cooperatively with staff and team members

Asks for help when needed Avoids inappropriate comments or offensive behavior

Appropriately evaluates andreads participant responses Provides clear and accurate direction

Covers all required material and exercises within time allowed

Consistently receives positive evaluations from class participants

Establishes group rapport Fully prepared for each class with clear, organized presentations

Stays within boundaries and topics of each class

Effectively teaches existing curriculum content as it is written

Handles transitions effectively Knowledge of the curriculum and its intended purpose

Understands and respects thevulnerabilities of class participants

Identifies and recommends improvements based on group feedback

Return this form and your letter of recommendation to: Training Director, Purpose Built Families Foundation,

9050 Pines Blvd., Suite 305, Pembroke Pines, FL 33024

NAME OF APPLICANT:

I have asked you to submit a letter of reference and recommendation for my application to be a candidate as a PAIRS Facilitator. Overall, the PAIRS Facilitator should be personable, have life experience, and be trustworthy, responsible, and caring. An effective facilitator should be someone who does not read the material off the printed page or PowerPoint in class; a person who has a sense of humor, healthy self-esteem, charisma, energy, enthusiasm, and life wisdom. These qualities may help you in considering what you have observed of me. Please be direct and as objective as possible in your assessment as we all have strengths and opportunities for growth. Your honest feedback is essential for my education as a facilitator. The qualities listed below have been found to be some of the most important characteristics of effective PAIRS Facilitators. Please rate me on the following scale:

1 = needs improvement; 2 = adequate; 3 = above average; 4 = superior; N/A = unknown

Rating Quality Rating Quality

Personal warmth Optimistic

Authenticity Poised

Maturity At ease with groups

Emotionally stable and comfortable with emotional intensity

Appropriate professional appearance and grooming

Relevant and appropriate self-disclosure Avoids wordiness, professional jargon terminology

Ability to maintain a safe educationalenvironment, including appropriate boundaries

Use of appropriate humor

Speaks clearly with appropriate pacing and expression, and is easily understood

Works cooperatively with staff and team members

Asks for help when needed Avoids inappropriate comments or offensive behavior

Appropriately evaluates andreads participant responses Provides clear and accurate direction

Covers all required material and exercises within time allowed

Stays within boundaries and topics of each class

Establishes group rapport Fully prepared for each class with clear, organized presentations

Knowledge of the curriculum and its purpose

Consistently receives positive evaluations from class participants

Handles transitions effectively Effectively teaches existing curriculum content as it is written

Understands and respects thevulnerabilities of class participants

Identifies and recommends improvements based on group feedback

Return this form and your letter of recommendation to: Training Director, Purpose Built Families Foundation,

9050 Pines Blvd., Suite 305, Pembroke Pines, FL 33024