Teacher Membership Application Form

Section 2 | Mindfulness TEACHER Training / Qualifications

Please complete either 2.1 or 2.2
2.1 MTAI-Recognised Training

If you have completed an MTAI recognised teacher training programme, please provide details below. (For approved training programmes, see MTAI Standards Document 2.1).
Title of Qualification
(Certificate, Diploma, Degree, Masters etc)
Awarding Body
Year of Award
Please attach a certified copy (scanned or a photo), of your Mindfulness Teacher’s qualification.

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2.2. Mindfulness Teacher’s Training not recognised by the MTAI

If you have not completed an MTAI recognised Mindfulness Teacher Training Programme, please provide details of your Mindfulness Teacher Training qualification (s)
Title of Award
(Certificate, Diploma, Degree, Masters etc)
Awarding Body
Date of Award
Duration of Training in Months
Number of in-person contact hours
Please attach a certified copy (scanned or a photo), of your Mindfulness Teacher’s qualification.

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Support your application with written details of:
- (a) in-person attendance at an MBSR/MBCT/Breathworks programme as a participant,
- (b) your personal mindfulness practice
- (c) retreats, continuous professional development activities
- (d) number of years of teaching MBSR/MBCT/Breathworks Mindfulness - please state how many courses you have taught.
(up to 700 words)
Support your application with written piece (see above paragraph)

0/700

Section 3 | MBSR/ MBCT or Breathworks Mindfulness Teaching

Please answer all questions
3.1 Have you taught an 8-week MBSR/ MBCT/ Breathworks Mindfulness course on your own?*

YesNo
3.2 Please provide a description of the supervision you have had to date
3.3 Please provide details of other types of Mindfulness Teaching you are involved in (other than MBSR/ MBCT/Breathworks) and are qualified to teach.

Section 4 | Professional Indemnity Insurance
Professional Indemnity Insurance is required for all MTAI Teacher members. Do you hold insurance currently, either in your own right or through the organisation where you teach mindfulness?*

YesNo
If no, please indicate you will take insurance immediately (There are preferential rates available for MTAI members with OBF insurance. This information is on the website)

Yes

Section 5 | Other

Please answer all questions
5.1 Are you in agreement to us contacting you further in relation to your application?*

Yes
5.2 I confirm I have read and agree to adhere to the MTAI Code of Ethics*

Yes
5.3 Signature

Clear
Should be Empty:

Section 1 | Personal Details