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Certification Application

Instructor and Healing Certification Application

Kindly fill out the Certification form below for Tai Chi Instructor, Qigong Instructor or Qigong Healing.  After the form is reviewed a staff member will contact you.


Tai Chi and Qigong Instructor or Healing Certification Application
First name
Last Name
Zip Code
Home Phone Number
Cell Phone Number
Fax Number
Email Adress
Present Occupation
Professional Training, Certifications and Educational History
Meditation, Martial and Healing Arts Experience
Why do you desire to become a Tai Chi or Qigong Instructor or a Qigong Healing Practitioner?

This is all the information we need at this moment. Thank you!