2019-2020 Qi-Energy Management Series Application

$25.00

Application to join the IQ&IM Qi-Energy Management Series.

Prerequisite for Series Application: Completion of all Yi Ren Qigong Foundation Levels I, II and III.

Non-refundable application fee is $25. Please fill all required fields to complete your application.

Personal Information

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Emergency Contact Information

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Interest in the Qi-Energy Management Series

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Yi Ren® Qigong Training

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Personal Cultivation History

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Previous Training and History

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References

Please provide as specified below three personal references. For the Yi Ren Qigong references, if possible, please use people that are not current members of the IQ&IM Board and Staff.

Yi Ren® Certified Instructor

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Yi Ren® Community Member

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Professional or Friend Reference

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Resume

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Electronic Signature

Qi-Energy Management Series Agreement

I affirm that the information that I have submitted is true, correct and complete.

I understand and agree that should my application for the Qi-Energy Management Series (QEMS) be accepted and I subsequently register for the QEMS, I am making a commitment to participate in the entire series and I am responsible for the entire series tuition should I choose to terminate, or IQ&IM terminates for cause, my participation in the QEMS prior to the series completion.

IQ&IM reserves the right to discontinue my participation in the QEMS at any time for reasons including but not limited to a lapse of good standing, falsification of information or participation in acts of behavior contrary to the IQ&IM Yi Ren® Student Participant Code of Ethics and Conduct:

Professional Behavior:          

  1. Maintain Professional Ethics and Student Confidentiality
  2. Maintain Compassionate Caring Behavior
  3. Maintain Respectful Communications
  4. Maintain Personal Health & Wellness
  5. Maintain Professional Boundaries

Yi Ren Student Participant Code of Ethics and Conduct:

  1. Adhere to high standards of professionalism, integrity, and honesty.
  2. Respect the rights and properties of students, colleagues, and other professionals, and safeguard all confidences and privacy.
  3. Maintain appropriate personal and professional boundaries and recognize that it is unacceptable to manipulate the energy and consciousness of others.
  4. Refrain from any substance abuse and model the highest standards of healthy behavior.
  5. Strive to prevent passive reactive behavior and misuse of energies including mental, emotional, spiritual, and sexual energy, or any kind of abuse.
  6. Conduct oneself without favoritism, prejudice, or discrimination with regard to age, race, creed, color, national origin, sex, honorably discharged veteran or military status, sexual orientation, or the presence of any sensory, mental or physical disability.

I understand and agree that should I participate in the QEMS, the information that is presented in the QEMS is for my personal use only and that nothing may be copied, shared or used by myself  for anything other than personal individual use without the express written permission of IQ&IM and Dr. Guan-Cheng Sun, PhD. and that all written, recorded or electronic media materials of any kind prepared, made, distributed, developed or in any way provided whether through personal delivery or by electronic means in during the QEMS are restricted.

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