RMTi Consultant - Application for Certification

RMTI Office Use Only
Consultant - Application for Certification
A student who has completed all of the requirements for certification as an RMTi Consultant, as outlined on the RMTi Website, may complete this form to initiate the process of becoming certified and licensed by RMTI.

After you submit this form, our Corporate Office will process your application and verify your requirements. Once your application has been verified and accepted:
1. You will receive an email with additional details, followed by an invitation to setup your RMTi Member Dashboard on the RMTi website.
2. You will login to the RMTi Member Dashboard to complete your Consultant Agreement and to pay your Annual Membership fees. Please note - The Annual Membership Fee is separate from, and not included in, the Application Fee you will pay when you submit this form.
Any questions about this process should be directed to our Corporate Office.
Step 1: Applicant Information
Applicant Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*

Confirmation EmailThis email address will be used to setup your RMTi login
Phone Number

Country CodeArea CodePhone Number
Website
If you have a website, you must list it here. If you do not, leave it blank.
What languages are you fluent in?
To select multiple languages hold the 'CTRL' key (for Mac this is the 'command' key)
What modalities are you qualified and/or certified in? Include dates when you obtained your qualifications and/or certifications. *
Outline your experience working in these areas of qualification and/or certification. *
What changes have you noticed in yourself since doing RMT? *
Do you agree that if someone contacts you, from the RMTi Website or any other source, specifically about Rhythmic Movements, that you will make RMTi a major component of that initial consultation? *

Yes, I agree.

Step 2: References

We require that you provide us with a minimum of two (2) work related references, whom we may contact to inquire about you. Please include Name, Address, Email Address, Telephone Number, and how they are associated with you.
Reference #1*
Reference #2*
List the names of any RMTi Instructors who supported you in the process of becoming an RMTi Consultant (i.e served as Mentors)

Step 3: Confirm Attendance in RMTi Levels One, Two, Three and Making Connections

Must complete all of the above.
Have you attended RMTi Level One?*

Yes
Who was your instructor for RMTi Level One? *
Have you attended RMTi Level Two?*

Yes
Who was your instructor for RMTi Level Two? *
Have you attended RMTi Level Three?*

Yes
Who was your instructor for RMTi Level Three? *
Have you attended RMTi Making Connections?*

YesNo
Who was your instructor for RMTi Making Connections? *

Step 4: Confirm Repeat Attendance in RMTi Level One OR Attendance RMTi for School Readiness

Must complete a minimum of one of the above.
Which have you completed? *

Repeat Attendance in RMTi Level OneAttend RMTi for School ReadinessBoth: Repeated RMTi Level One and Attend RMTI for School ReadinessAttend an RMTi Intensive
Who was your instructor for repeat attendance in RMTi Level One? *
Who was your instructor for RMTi for School Readiness? *
Who was your instructor for the Intensive course? *

Step 5: Confirm Repeat Attendance in RMTi Level Two OR Attendance in RMTi Face the Fear OR Attendance at an RMTi Intensive

Must complete a minimum of one of the above.
Which have you completed? *

Repeat Attendance in RMTi Level TwoAttend Face the FearAttend an RMTi IntensiveBoth: Repeat Level Two & Attend Face the FearBoth: Repeat Level Two & Attend IntensiveBoth: Attend Face the Fear & Attend Intensive
Who was your instructor for repeat attendance in RMTi Level Two? *
Who was your instructor for RMTi Face the Fear? *
What were the dates and location of the RMTi Intensive?*

Step 6: Upload 3 Completed Case Studies

A minimum of 3 case studies are required to apply. We require that you have seen the person a minimum of 3 times for each case study. Upload using the links below.
Have your case studies been reviewed by a current RMTi instructor? *

YesNo
Name of RMTi Instructor who reviewed your case studies*
Would you like us to assign an instructor to review your case studies and provide feedback for a fee of $5 USD per case study? *

YesNo, I will ask an instructor to review my case studies, and then I will re-submit them to the office. I understand that my application is not complete until I submit reviewed case studies.
Case Study 1*

Upload a File

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Case Study 2*

Upload a File

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Case Study 3*

Upload a File

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Step 7: Pay Application Fee

RMTi has a tiered system for pricing, including application fees. If your country is listed on the Tier 2 list, select it and pay the Tier 2 Application fee. If your country is not listed, then you live in a Tier 1 country and should pay the Tier 1 Application fee.
Tier 2 Countries*
If your country is listed here, select it, and pay Tier 2 pricing. If not, you are in a Tier 1 country and are required to pay Tier 1 pricing.

My Products*

Tier 1 Application Fee$75.00

Tier 2 Application Fee$25.00

Enter coupon

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

English
Chinese (Mandarin)
Spanish
Arabic
Bengali
Hindi
Russian
Portuguese
Japanese
German
Korean
French
Turkish
Vietnamese
Telugu
Chinese (Cantonese)
Marathi
Tamil
Italian
Urdu
Gujarati
Polish
Ukrainian
Persian
Malayalam
Kannada
Oriya
Panjabi (Western)
Sunda
Panjabi (Eastern)
Romanian
Bhojpuri
Azerbaijani (South)
Maithili
Hausa
Burmese
Serbo-Croatian
Awadhi
Thai
Dutch
Yoruba
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Bahasa Indonesian
Afrikaans
Bahasa Malaysia
Norwegian
English with Japanese Translation
English with French Translation
English with Portuguese Translation
English with Arabic Translation
English with Cantonese Translation
Cantonese and English
English with Spanish Translation

Consultant - Application for Certification

Step 1: Applicant Information

Step 2: References

Step 3: Confirm Attendance in RMTi Levels One, Two, Three and Making Connections

Step 4: Confirm Repeat Attendance in RMTi Level One OR Attendance RMTi for School Readiness

Step 5: Confirm Repeat Attendance in RMTi Level Two OR Attendance in RMTi Face the Fear OR Attendance at an RMTi Intensive

Step 6: Upload 3 Completed Case Studies

Step 7: Pay Application Fee