Qualified Mentor / Instructor Advancement Application

You may only upload your application as a single .pdf file. All application requirements and forms must be contained in this one .pdf file.

Your packet file should be named as follows: last name_first name_abbreviated appplication title_year.pdf. Please include the underscore "_" as indicated. Abbreviated application title is QM for the Qualified Mentor application and IA for the Instructor Advancement application.

First Name*
Please let us know your first name.

Last Name*
Please let us know your last name.

Email*
Please let us know your email address.

Address*
Please let us know your address.

City*
Please let us know your city.

State/Province*
Please let us know your state or province.

Country*
Please let us know your country.

Zip/Postal Code*
Please let us know your zip/postal code.

Phone Number*
Please let us know your phone number.

Application Options*
Please select your advancement option.

Before you upload your application, your file name should be: last name_first name_abbreviated appplication title_year.pdf. Your file size should not exceed 32 megabytes.

Upload Application*
Please attach your packet and be sure the file extension is pdf. Files can be no larger than 32 megabytes.

Payment Type

If you choose to pay by check please send your check within 5 business days and note clearly what your check is for. Please make your check payable to Healing Touch Program.

Send payment to:

Healing Touch Program
20822 Cactus Loop, San Antonio, TX 78258

Total
0.00 USD

Antispam*
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