INSTRUCTOR INFO FORM

If you are interested in being an instructor at a World Massage Festival™,
please complete the form below and
we will contact you with details.

PLEASE NOTE that most classes at the WMF must be NCBTMB-approved!

Your Name:
Your Company:
Mailing Address:
City, State & Zip:
Your Biography:

Class Name & # of CEs:
Course Description:

Supplies therapists need
to bring to class:

Class Name & # of CEs:
Course Description:

Supplies therapists need
to bring to class:

Class Name & # of CEs:
Course Description:

Supplies therapists need
to bring to class:

Class Name & # of CEs:
Course Description:

Supplies therapists need
to bring to class:

Office/Home Phone:
Cell Phone:
Email:
Years of Teaching:
1-3 4-6 7-10 Over 10
Approved Provider For:
NCBTMB - Provider #
States:

Other:
Comments & Questions:



It is the responsibility of the speaker/teacher to contact the CE Brokering Agent of each state where therapists are licensed and make arrangements for their workshop classes to be acceptable. The Festival will provide each speaker/teacher with a list of therapists who attended their classes.


World Massage Festival * festival@worldmassagefestival.com * 336-957-8997