$125.00

This Agreement is for previously certified Yi Ren^® Qigong Certified Instructors who are wishing to renew their Yi Ren^® Qigong Instructor Certification in order to be able to continue to teach the 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 *
Recommendations for Yi Ren® Certified Instructors
Have you practiced the recommended minimum Yi Ren® Qigong for at Least 300 hours per year for the previous two year period? *	Yes No
Have you kept the recommended practice log, recording time and personal reflections and experience of your internal cultivation? *	Yes No
Yi Ren® Class Instruction
Have you taught any Yi Ren® Qigong classes in the past two-year certification period? *	Yes No
Please list the Yi Ren® Qigong classes you have taught from 2017 to 2019, including year taught. If you have not taught any classes please indicate Not Applicable. *
Yi Ren® Qigong Certified Instructor Classes Attended \| July 2017 - July 2019
Twenty-four hours of instructor focused continuing education taken during each certification period is required for re-certification. Advance Practitioner seminars such as The Secret of the Golden Flower do not count towards re-certification.
Please list, including dates, the Yi Ren® Qigong Certified Instructor Classes that you attended in past two years. *
Upload Completed 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. *

Checkbox
I agree to both IQ&IM's Class Participation Waiver and 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 Re-Certification Agreement

Yi Ren Qigong Instructor Agreement PDF Link

Personal Information

Emergency Contact Information

Recommendations for Yi Ren® Certified Instructors

Yi Ren® Class Instruction

Yi Ren® Qigong Certified Instructor Classes Attended | July 2017 - July 2019

Upload Completed Agreement PDF

Checkbox

Electronic Signature