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EMF Balancing Technique®
Teacher Website Listings & Contact Details

This form serves three purposes - Information to post on the web listing to the public (the way the public contacts you), Bio and Schedule to post on the Teacher web listing to the public (the way the public contacts you), and information for the EEI database (the way EEI contacts you).
Please submit this form in the same envelope with your original signed License Agreement and Policy.

How to Work with this Form
:
  Type information into all boxes that apply. Print 2 copies of the form - one for EEI and one for your records. (File, Select Print)

This entire form MUST be TYPED and a hard copy submitted to EEI

*Part A - Practitioner Web Site Listing for Teachers (optional)

*If you do not wish to be listed at this time go to Part B.

 
   First Name    Last Name
 Address: 
City, Province, or Canton:
   State:
Zip Code or Postal Code:    Country:

Email:
Telephone Number:
 
                     (include country code if outside of USA)                     

Level: Please check all that apply:
Supervisory Teacher Phases I-IV
      Supervisory Teacher Phases I-IV & Accredited Practitioner V-VIII
Supervisory Teacher Phases I-IV & Accredited Practitioner IX-XII

Part B – EEI Data Base Contact Details
 

If your contact details for EEI are the same as Part A check here
 
 
If your contact details are different from Part A, please TYPE below how you wish to be contacted by EEI 

First Name    Last Name
Address:  
City, Province, or Canton:
   State:
Zip Code or Postal Code:   Country:
Telephone Number:
 Email:

Part C – Teacher Web Site Listing and Schedule  

We have asked all Teachers to send in a bio according to the EMF bio guidelines (click here to review the bio guidelines), and a schedule of at least two full trainings for the year to be posted online. All teachers must have a bio and schedule of two trainings, this is a requirement in order to maintain your Teacher listing on the web site.

Please select one of the three options:

I have not yet submitted a bio according to the EMF bio guidelines.  I will review the bio guidelines at this link and submit my bio for review. I will also submit my two 6 day trainings for the online schedule page with my bio to register@emfworldwide.com. (Email schedule and bio)

I have already submitted a bio according to the guidelines. My correct details and bio are listed online. I also have at least two full trainings (two 6 day trainings) listed on the EMF schedule page.

I have already submitted a bio according to the guidelines. My correct details and bio are listed online, but I will need to submit my two 6 day trainings for the online schedule page. register@emfworldwide.com (Email schedule)

Please allow 3 weeks for the bio review to take place and to receive a response from one of the EEI team members.

Notes: You will receive a confirmation that we have received your License Agreement and Web/Contact details form.
If you do not receive a confirmation within 1 month after submitting your forms please email
register@emfworldwide.com .

Mail in the same envelope: a hard copy of this form (must be typed) with the original (not a copy) signed License Agreement to:
The Energy Extension, Inc.  Att: License Dept. PO Box 4357  SedonaAZ  86340  USA