1, Dear Certified. Instructor. HealingTouch. thank you

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1 INSTRUCTOR CERTIFICATION RENEWAL APPLICATION AND GUIDELINES JANUARY 1, 2015 DECEMBER 31 UPDATED MAY , 2017 Dear Certified Instructor, Welcome to Healing Touch International s (HTI) Healing Touch Instructor Certification Renewal process. We are pleased that you have made the commitment to continue as a HTI Certified Healing Touch Instructor. We acknowledge and thank you for your work in spreading healing light through Healing Touch classes. Each of the instructor certification criteria are meant to highlight specific knowledge, skills, or judgment related to professional and ethical teaching. Please utilize the specific instructions for each criterion, as well as the general instructions regarding the application s format and process. We thank you for renewing your commitment to excellence as a HTI Certified Healing Touch Instructor. In Light, HealingTouch International - Board of Directors HealingTouch International - Certification Board

2 Table of Contents Page Title 3 General Information and Directions 4-5 Instructor Criteria 6 Application for Renewal of Instructor Form 7 Instructor Renewal Checklist 8-9 Instructor Peer Review Form (optional for Criterion 4) 10 Recommendation for Renewal Form (Criterion 5) July 1996, Healing Touch International Revised/Approved 1999, 2002, 2005, 2008, 2012, 5/ CHTI CERTIFICATION RENEWAL HTI, ALL RIGHTS RESERVED

3 General Information and Directions 1. Instructors must have a current HTI Instructor Certification through Healing Beyond Borders to teach in the HTI Healing Touch Certificate Program. This certification is effective for five years. Renewal applications must be submitted to the office of Healing Beyond Borders at least 30 days before the expiration date of your current certification. 2. Renewal of your HTI Instructor Certification is based on the evidence presented in your portfolio regarding your: a. Activity as a member in the HTI instructor group; b. Ongoing Certification as a HTI Healing Touch Practitioner; c. Record of continuing education regarding teaching; d. Teaching of classes for Course 1; e. Quality of teaching as evaluated by a peer. 3. Renewal extends your certification for five years, which allows students in your classes to progress in the HTI Healing Touch Certificate Program. 4. If your certification expires, you will no longer be able to use the title Certified Healing Touch Instructor (CHTI) in your correspondence or in representing Healing Touch to the greater community. If you wish to become a HTI Certified Healing Touch Instructor following expiration of your certification, certain requirements must be met. An explanation of these requirements can be obtained from the Healing Beyond Borders office. 5. Application Procedure a. Submit a completed application form, application fee, and all required materials. b. One copy of the completed application form may be submitted to the Healing Beyond Borders office either by mail, fax, or (scanned electronic signature required). c. Retain one complete copy of your application for your records. 6. Non-refundable Application Fee is $ U.S. Send the completed application form and all required materials along with the fee. Credit card - pay online (VISA, MC, DISCOVER, AMERICAN EXPRESS) Go to Click on OUR STORE, then CERTIFICATION FEES. Add to Cart CHTI Re-Certification Member Renewal Fee. Print the receipt and attach a copy to your application. Non-Credit Card Payments: Include your check payable to Healing Beyond Borders 7. To ensure you have included all required application materials, please use the application checklist on page 12. Do not enclose the checklist with your application. 8. Forward one copy of the application package to: Healing Beyond Borders Certification 445 Union Blvd. Suite 105 Lakewood, CO Phone Fax: Certification@HealingBeyondBorders.org CHTI CERTIFICATION RENEWAL HTI, ALL RIGHTS RESERVED

4 Criterion 1: Current HTI Certification as a HTI Healing Touch Practitioner and Instructor Current HTI certification as a Healing Touch Practitioner and Healing Touch Instructor Action/Evidence Required Original and Renewal Certification Information (Application Form p. 6) o Date of original HTI PractitionerCHTP certification, certification number, and renewal date (information to be inserted on the application form). o Date of original HTI Instructor (CHTI) certification, certification number,and renewal date. Submit a copy of your current CHTP certificate Criterion 2: Record of HTI Level 1 Healing Touch Classes Taught Demonstrate an established and current teaching record of at least five HTI Healing Touch Certificate Program Course 1: Foundations of Healing Touch classes during the last five years. One HTI Course 1 class must have been taught during the last 12 months. Action/Evidence Required Submit in typed form, single-spaced on one page, in chronological order. Attach a list, including date and location of HTI Healing Touch Course1 classes taught in the last five years since original instructor certification or last renewal. Criterion 3: Self Evaluation Statement Write a Self Evaluation Statement, including teaching experiences and expertise, and future goals. Action/Evidence Required Submit in typed form, single-spaced on one page. Attach a Self Evaluation Statement describing teaching experiences, current teaching expertise, and goals for future development. Attach a record of other HTI Healing Touch Certificate Program courses taught. Group the list by course, including date, location, and Co-Instructor name, if applicable. Criterion 4: Documentation of Continuing Instructor Education Documentation of continuing education to build a knowledge base about energy healing, networking, and building community among instructors; updating instructor s skills to match changes in the certificate program; and maintaining standardization of techniques. Action/ Evidence Required 1. List dates and locations of a minimum of three out of five HTI or HTI Affiliate Country Instructor Meetings attended during the last five years. Title Location Date CHTI CERTIFICATION RENEWAL HTI, ALL RIGHTS RESERVED

5 If you were unable to attend one or two of the required meetings, you may meet by phone, e- mail, or in person with a certified instructor who attended the HTI Instructor Meeting to discuss the content of the meeting. Summarize your discussion in one to two paragraphs, and include the peer instructor s name and the date you met. AND You may choose either item 2 or item 3 below. You are not required to do both. 2. Documentation of at least three activities to maintain expertise as an adult educator (e.g., observing another HTI Certified Instructor teaching, reading books or articles, or attending workshops or seminars). For each activity, include a brief summary and evaluation of how each activity applies to your instructor role (use one page, single-spaced). 3. Instructor Peer Review. As you teach a Course1 class, have another HTI Certified Instructor review at least three hours of your teaching.this class must be within the five years prior to this renewal. Have the CHTI complete theinstructor Peer Review Form (see page 5) Alternate ways to meet requirements for Peer Review: Co-teach a HTI Course1 class with another certified instructor and have that person review you. Attend a HTI Course 1: Foundations of Healing Touch Instructor Training (free of charge with advanced notice of attendance). Criterion 5: Recommendation for Renewal of Instructor Certification froman ExperiencedHTI Certified Instructor Recommendation for renewal of Instructor Certification from an experienced HTI Certified Instructor. Action/Evidence Required Completed recommendation form (page 10) from an experienced HTI Certified Instructor. Criterion 6: Current Membership in Healing Beyond Borders Current membership in Healing Beyond Borders Applicants must have and maintain an active membership in Healing Beyond Borders Purpose To be recognized as part of a professional organization.to provide a resource for ongoing information, networking, referrals, and continuing learning in the field, and to receive educational materials. Action/Evidence Required Include proof of HBB membership CHTI CERTIFICATION RENEWAL HTI, ALL RIGHTS RESERVED

6 Application for Renewal of HTI Instructor Certification Name Last First MI Credentials Address City State/Province Code Preferred Phone Cell Phone Work Phone Date of Application Original Practitioner Certification Date Original Instructor Certification Date HTI Membership Number CHTP # Last Renewal Date CHTI #Last Renewal Date Applicant s Statement of Professional Responsibility Recognizing there are many areas of subtlety that cannot be established by written materials alone, you are asked to attest to the truth of the following statements. Yes No I have read the HTI Instructor Guidelines and attest that my teaching practice adheres to these Instructor Guidelines. Yes No I have read and attest that my practice adheres to the Code of Ethics and Standards and Scope of Practice Statement as published by Healing Beyond Borders. Yes No I take responsibility to obtain and maintain appropriate legal credentials or qualifications necessary to touch the human body as required in my state or geographical area. Yes No Have you ever been convicted of a felony? If yes, please attach explanation. Yes No I attest the above statements are true. Date Signature of Applicant CHTI CERTIFICATION RENEWAL HTI, ALL RIGHTS RESERVED

7 Instructor Renewal Checklist Please use this checklist to ensure your application is complete. Do not return this checklist with your application. Completed Application Form Criterion 1: Current HTI Practitioner Certification and Current HTI Instructor Certification Criterion 2: Record of HTI Certificate Program Course1 classes taught Criterion 3: Self Evaluation Statement Criterion 4: Documentation of Continuing Instructor Education Meeting/Conference Activities OR Instructor Peer Review Form (pp.8-9) Criterion 5: Recommendation for Renewal of Instructor Certification from an Experienced HTI Certified Instructor (p.10) Criterion 6: Current Membership in HTI This information is on file. If your membership is not current, please contact the HTI certification administrator. Check, Money Order, or Credit Card process for Renewal fee $100 U.S. Be sure to keep a complete copy of your application. Your application will not be returned to you CHTI CERTIFICATION RENEWAL HTI, ALL RIGHTS RESERVED

8 Instructor Peer Review Form (Criterion 4 optional) (Peer review must be completed by an experienced and active HTI Certified Healing Touch Instructor) Teaching Activity Checklist Applicant s Name Class LocationDates Last Name First Name MI Peer CHTP/I Name Phone Introductions/Opening Meditations Time: Suggested / Allotted Comments Overview of Healing Touch (1-2 hr) Definition, History, Benefits, Theory, HTI and Certificate Program Overview, sensing energy Framework for HT Session Presentation Demonstration Seven Steps (2 hr) Human Energy System Energy Field/Chakra lecture Assessment: Pendulum, Hand Scan, Sensing EF, other Modified Mesmeric Clearing Demonstration Exchange & Sharing (2 hr) (1-1 ½ hr) Chakra Connection Demonstration Exchange & Sharing (1 ½ -2 hr) Clinical Applications Pain Mgmt (½ -1 hr) Laser(s), Siphon, Pain Spike Pain Ridge, Wound Care CHTI CERTIFICATION RENEWAL HTI, ALL RIGHTS RESERVED

9 Headache Management Time: Suggested / Allotted Comments Sinus Tension Migraine Head Trauma (½ -1 hr) Noel s Mind Clearing Scudder Meridian Clearing Development of Healer Self-Care / Journaling Heart to Heart Connection Chakra Spread Demonstration Exchange /Sharing Legalities, Ethics Scope of Practice (½ -1 hr) (½ -1 hr) (½ -1 hr) (1-2 hr) (½ 1 ½ hr) Supervisor Comments: Opportunities for Improvement: Signature of Peer Instructor HTI Certified Healing Touch Instructor (Observer) Date Name/Credentials of Peer (Print clearly) Date Certified/Renewed CHTI CERTIFICATION RENEWAL HTI, ALL RIGHTS RESERVED

10 Criterion 5: Recommendation for Renewal of Instructor Certification from an Experienced HTI Certified Instructor Applicant s Name The applicant has demonstrated that she/he is a competent instructor of Healing Touch as evidenced by: Provide a brief statement relative to your knowledge of the applicant: - Does the applicant adhere to the HTI Instructor Guidelines? Yes No - Does the applicant adhere to the HTI, Inc., Code of Ethics and Standards Yes No and Scope of Practice? - I would refer students to this Instructor. Yes No - I recommend this applicant for renewal as a Certified Healing Touch Instructor. Yes No Supporting Remarks ( No responses require a brief explanation; Yes response may be supported if desired): Signature and credentials of Peer HTI Certified Instructor Date Printed Name of Peer HTI Certified Instructor Peer Instructor Certification Original and Renewal Date(s) PhoneNo. address Mailing Address of Peer Instructor CHTI CERTIFICATION RENEWAL HTI, ALL RIGHTS RESERVED

11 Appendix 1 Application Review Information Feedback to Applicants Applicants receive a letter indicating the status/outcome of the evaluation. Approved: The applicant will receive a letter of approval from the HTI Certification Board and a Certificate of Certification as an HTI Healing Touch Instructor awarded for a period of five years. Approval Pending: This status indicates the action required by the applicant to meet the requirements and is accompanied by a feedback report. This report provides direction for submission of additional material(s) requested by the reviewers Applicants have 60 days to submit updated materials. If the resubmitted materials meet the criteria, the application will be designated as Approved. If the materials do not meet the criteria, the application may be designated Not Approved. Not Approved: This status results from a consensus of the Certification Board. The letter will clearly indicate the reasons/rationale for a Not Approved status. An appeal process is available for Not Approved status and is described below. Grievance Procedure If an applicant receives a Not Approved and disagrees with the decision, she/he may appeal in writing to the Healing Touch International Certification Board within 60 days of notification. The Healing Touch International Certification Board will consider the appeal and respond to the applicant within six (6) weeks. Their response will either confirm the Not Approved status or will modify the status as warranted. The applicant must send 4 copies of the original packet and letter of appeal to: Healing Beyond Borders. Certification Board 445 Union Blvd., Suite 105 Lakewood, CO Appeal Instructor Certification CHTI CERTIFICATION RENEWAL HTI, ALL RIGHTS RESERVED