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The International Center for Reiki TrainingAPPLICATION FOR ADMITANCE INTO THELICENSED TEACHER PROGRAMName _____________________________________Date of Birth______________Mailing Address:Street______________________________ City_______________________State/Country_______________________Zip/Postal Code _____________Office Address:Street _____________________________City _____________________State/country ______________________Zip/Postal Code _______________Home phone ________________ Office Phone ______________ Fax ____________Email ______________________Personal website __________________________ICRT TrainingReiki I Date Teacher Certificate Enclosed Y/NReiki II Date Teacher Certificate Enclosed Y/NART Date Teacher Certificate Enclosed Y/NMaster Date Teacher Certificate Enclosed Y/NKaruna Reiki Master Certificate Enclosed Y/NCertificates must be submitted for these classes before your application can beconsidered.Reiki Training with other SchoolsOn a separate sheet of paper list classes, dates, and teacher of all your previous Reikitraining and hours of training at each level. Copies of your certificates should be sent tothe address on the front of this manual.Educational BackgroundOn a separate sheet of paper list:High School attended, address and dates of attendance.College(s) OR vocational schoolsyou attended, address and dates of attendance, degrees awarded.Other spiritual healing training you have attended, address and dates of attendance,certificates or degrees awarded:Graduate work, school attended, address, dates of attendance and major/minor24 | P age
ICRT Application for Admission into TLC Program - Page 2List Names of References and Phone numbers:Employer:Name Phone Number____________________________________Personal:Name Phone Number____________________________________Students:Name Phone Number____________________________________Name Phone Number____________________________________Name Phone Number____________________________________Name Phone Number____________________________________Name Phone Number____________________________________Clients:Name Phone Number____________________________________Name Phone Number____________________________________Name Phone Number____________________________________Reiki Teacher(s):Name Phone Number____________________________________Please include a current photo of yourself with your application.Do you hold any certifications, licenses in traditional medicine, complementarymedicine, or psychology? If so, list and give your training. Use the back of this page ifnecessary.Please list your employment record for the past five years, stating how long at eachposition, name of supervisor and phone number. Describe your work responsibilities ateach position. (Use the back of this page if necessary)25 | P age
Page 1 and 2: The International Centerfor Reiki T
Page 3 and 4: About theInternational Center for R
Page 5 and 6: About theReiki MasterTeacher Licens
Page 7 and 8: them a unique gift of being able to
Page 9 and 10: Goals and Purpose of the TLC Progra
Page 11 and 12: Ethical Standards (continued)14. Ed
Page 13 and 14: The Application ProcessAn Overview
Page 15 and 16: Requirements to Fulfill Upon Accept
Page 17 and 18: Requirements to Teach Advanced Leve
Page 19 and 20: Requirements to Maintain Status as
Page 21 and 22: Karuna Reiki® Practitioner Level I
Page 23: Letter of Intention to Become an IC
Page 27 and 28: International Center for Reiki Trai
Page 29 and 30: INTERNATIONAL CENTER FOR REIKI TRAI
Page 31 and 32: International Center for Reiki Trai
Page 37 and 38: Client Review Form for Reiki Sessio
Page 39 and 40: Class Review FormsClass ReviewStude
Page 41 and 42: Advanced Reiki/Reiki Master Class R
Page 43 and 44: Miscellaneous FormsProfessional Con
Page 45 and 46: Reiki Symbol QuizTeachers Name: ___
Page 47 and 48: Reiki Documentation FormClient Name

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