$ 125.00 This Agreement is for students who have just completed their Yi Ren ® Qigong Teacher Certification Training Program requirements and would like to become a Yi Ren ® Qigong Certified Instructor in order to be able to teach Yi Ren ® Qigong Foundation Levels I, II and III. Once your completed Agreement has been submitted and reviewed, you will be sent a link to a Certified Instructor’s page where you will find Instructor Resources and a link to provide contact information should you wish to have your contact information listed on the website. The required waivers are also available on the Resource page. As additional resources are created, they will be posted on these Instructor only pages to which you will have access as long as you maintain your Yi Ren ® Qigong Instructor Certification. Yi Ren Qigong Instructor Agreement PDF Link PLEASE NOTE, to be valid, this Agreement requires both an electronic signature and a fully completed and signed PDF of the ENTIRE Agreement to be uploaded with payment of the fee. If re-submission of the Agreement is necessary, your payment will be refunded minus an administrative fee of $30. Personal Information First Name * Last Name * Email Address * Phone number * Emergency Contact Information Name * Relationship to You * Phone number * In Order to Become a Yi Ren® Qigong Certified Instructor, Please Affirm That You Have Successfully Completed the Yi Ren® Teacher Certification Training Program Requirements for Certification. Yearly Yi Ren® Practice Requirements — Minimum 300 Hours per Year & Seven Quarterly Reports Have you practiced Yi Ren® Qigong for at least 300 hours per year for the previous two year period? * Yes No Have you submitted either to your TCTP Mentor or IQ&IM your seven required Quarterly Practice Logs? * Yes No TCTP Peer Group Practice — Twenty-Four Practices Have you completed your twenty-four required Peer Group Practices? * Yes No Have you submitted to either your TCTP Mentor or IQ&IM your Peer Group Practice Logs for your twenty-four peer practices? * Yes No Mentor Review Sessions — Eight Sessions Have you completed your eight Mentor Review Sessions? * Yes No Have you submitted your Mentor Review logs for all of your eight required Mentor Reviews to either your TCTP Mentor or IQ&IM? * Yes No Annual Reports — Two Reports Have you submitted either to your TCTP mentor or IQ&IM your two annual reports? * Yes No Final Project Please upload a PDF of your final project. If you chose to do a presentation, please upload your written report of your final presentation. * TCTP Teacher Assisting Have you teacher assisted Yi Ren® Qigong Level I? * Yes No Have you turned in your Teacher Assistant logs to your TCTP Mentor or IQ&IM? * Yes No Please list the classes you have assisted, including Level and with which Certified Instructor. * TCTP Seminar Attendance Requirements TCTP Seminar Attendance — Twelve Seminars Have you attended in person all twelve of the required TCTP Seminars? * Yes No IF YOU MISSED ANY of the TCTP SEMINARS, please list the seminars and indicate whether or not you have paid tuition and received the audio recording, knowing that to maintain your certification you will need to attend the seminars in person when they are offered during the next TCTP. If you attended all twelve indicate Not Applicable. * Advanced Practitioner Seminar Attendance | September 2017 to September 2019 Please list, including dates, the Advanced Practitioner Seminars attended from September 2017 to 2019 for a total of at least twelve seminar hours. * Service Thank you! Though a TCTP requirement, your support of your fellow students and the IQ&IM community is also greatly needed and deeply appreciated. Please indicate the service(s) that you performed during your participation in the TCTP. This can include special projects, helping at seminars and IQ&IM events, etc. * Upload Completed Instructor Agreement PDF Please download the Instructor Agreement using the link at the top of the page. Read carefully, enter your name in the blanks, sign and upload the FULLY COMPLETED AGREEMENT. * Electronic Signature Note: This item requires you to electronically sign an agreement. Please review the text and provide your name below. I acknowledge and agree that I unless have completed my instructor certification by entering into and maintaining an Agreement with The Institute of Qigong & Integrative Medicine (IQ&IM) that I may not to teach the methods or information obtained in any Yi Ren ® Qigong program to others. I acknowledge that this Yi Ren ® Qigong Certified Instructor Agreement shall be effective and binding upon me. Furthermore, I understand that by signing this Agreement, I acknowledge that I have read, understood, and accepted all the terms and conditions as stated in the Yi Ren ® Qigong Certified Instructor Agreement. Signature: * 2019-2021 Yi Ren® Qigong Certified Instructor Agreement | First Time Instructor quantity Add to cart