TET Tapping Mentoring Program Application

This form collects your name, address, phone number, email address and other personal information related to your request to participate in the TET Tapping Mentoring Program with Jan Luther and The EGO Tamer® Academy (a service of The Rejuvenation Station, LLC). Please click here if you would like to view our Privacy Policy and see how we protect and manage the information you submit.

I consent to having Jan Luther and The Rejuvenation Station, LLC collect my personal information using this form. *

Yes

Full Name *

First Name (by which you'd like to be called) *

Email Address *

Address *

Address

Street Address

Apartment/Suite

City

State/Province

Zip/Postal

Country

Birthdate (We need this so we can verify you're over the age of 18.) *

Home Phone Number (XXX-XXX-XXXX format please) *

Mobile Phone Number (XXX-XXX-XXXX format please) *

Which phone number should we call to reach you in the event of a last-minute rescheduling of a call or class? *

Home Phone

Mobile Phone

Do you have a website? *

Yes

No

What is your website address? (Example: http://www.mywebsite.com)

Which of the following social media accounts do you have? *

Please enter the Facebook page address for your Fan Page (your personal page is okay if you don't have a Fan Page). (Example: https://www.facebook.com/TheJanLuther/)

Please enter the number of Facebook followers you currently have.

Please enter the Twitter address. (Example: https://www.twitter.com/JanLutherEFTPro/)

Please enter the number of Twitter followers you currently have.

Please enter your Instagram address. (Example: https://www.instagram.com/thejanluther/)

Please enter the number of Instagram followers you currently have.

Please enter your LinkedIn address. (Example: https://www.linkedin.com/in/janluther/)

Please enter the number of LinkedIn followers you currently have.

Please enter your Google+ address. (Example: https://plus.google.com/u/yourname)

Please enter the number of Google+ followers you currently have.

Have you completed TET Tapping Level Two training with Jan Luther? *

Yes

No

Have you completed TET Tapping Level Two training with a certified TET Tapping Practitioner? *

Yes

No

Please give us the name of your trainer and the date you completed the training.

Which of the following EFT specific training programs have you completed?

EFT Level One

EFT Level Two

EFT Level Three

None

Please give us the name of your EFT Level One trainer and the date you completed the training.

Please give us the email address for your EFT Level One trainer.

Please give us the name of your EFT Level Two trainer and the date you completed the training.

Please give us the email address for your EFT Level Two trainer.

Please give us the name of your EFT Level Three trainer and the date you completed the training.

Please give us the email address for your EFT Level Three trainer.

Have you taken and passed the TET Tapping Level Two Assessment with a score of 80% or higher? *

Yes

No

Have you personally paid for private TET Tapping sessions? *

Yes

No

How many private TET Tapping sessions have you paid for?

I am requesting to participate in the TET Tapping Mentoring Program at The EGO Tamer Academy for the following reason(s). (Check all that apply.) *

I want to have TET Tapping mentoring strictly to improve my skills and confidence in using TET Tapping for my personal use and with my family. (I do not need to meet the certification requirements.)

I want to use TET Tapping at my place of employment. (I need the mentoring and certification to improve my skills and confidence and to signify that I am qualified to offer TET Tapping as part of my skill set.)

I am adding TET Tapping to my existing business.

I want to start a TET Tapping coaching practice and I've previously owned a business.

I want to start a TET Tapping coaching practice and I've never owned a business.

What is the primary product or service that you offer in your existing business?

I can make myself available to attend the coaching and mentoring calls (select all that apply): *

Friday Mornings - 10:00 AM - 11:30 AM (Eastern Time)

Tuesday Evenings - 7:00 PM - 8:30 PM (Eastern Time)

Thursday Evenings - 7:00 PM - 8:30 PM (Eastern Time)

I feel that I'll have the full support and encouragement of my partner/spouse and children. *

Yes

No

How will this affect your ability or determination to complete the TET Tapping certification process?

The demographic I most want to serve using TET Tapping is: *

Women

Men

Children

Couples

If I were to choose a single theme or topic (niche market) to serve with my TET Tapping practice, it would be: *

What is your greatest fear or concern related to the TET Tapping certification process? *

What is your greatest fear or concern (self-doubt) about offering TET Tapping to the public? *

As a certified practitioner of TET Tapping, what will be your primary business model? *

1 to 1 Private Sessions

Small group workshops on specific topics (20-50 people)

Large group seminars on specific topics (50 to thousands of people)

Corporate or business training

Paid speaking

Writing and selling my book(s)

Other

If you selected "Other" above, what will be your primary business model?

Please briefly tell us your big dream for how you will use TET Tapping going forward. *

Do you currently hold additional certifications or licenses? (i.e., Hypnotherapist, Massage Therapist, Reiki (what level), etc.?) *

Yes

No

Please list all pertinent certifications/licenses that you currently hold.

Is there anything else you thing that Jan needs to know prior to your interview with her? (500 words or less) *

Just for fun, tell us a little bit about why you are a perfect candidate for TET Tapping mentoring and certification. *

I understand that, in addition to a monthly mentoring program subscription payment, there may be additional purchases required. I am committed and prepared to devote at least 3 hours per week for the next 12 months to complete the mentoring and certification process. I also understand that once I have signed my agreement contract for mentoring at The EGO Tamer Academy that there are no refunds. *

I understand and agree

I also understand that in addition to mentoring provided by Jan Luther, there will be other certified TET Tapping Practitioners, Mentors and Trainers participating in and supervising portions of my mentoring program and that they are covered under the same TET Tapping Mentoring Program Terms and Conditions to which I have agreed. *

I understand and agree

If you've completed all the questions, please click the Submit button below, As part of my review process, I meditate and pray over each submission so please be patient. I promise I'll be in touch via email or phone once I finish my review.

Upon clicking the Submit button, you'll be automatically directed to PayPal to pay your application/interview fee of $250.00. Thanks for your time and for your interest in our programs at The EGO Tamer Academy!

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