Name

First

Last

Email

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Business Name (If Applicable)

Website or Social Media Links

What is your current profession or business focus?

Which of the following IPHI programs are you interested in licensing?

If Selected Other Above, Please Specify

Have you completed any IPHI certification programs? If Yes, please list which one(s).

What other relevant certifications or credentials do you hold?

Why do you want to license and teach IPHI certification programs?

How do you plan to integrate IPHI programs into your current or future business?

What communities or populations do you plan to serve?

What are your short-term and long-term goals as an IPHI Licensee?

What does holistic, integrative education mean to you, and how does it align with your values?

Do you have experience teaching, mentoring, or leading workshops? If yes, please describe.

Do you currently have (or plan to create) a business platform (website, email list, LMS, etc.)?

Are you prepared to invest time, energy, and financial resources in growing your licensed business over the next 12 months?

Do you currently have a team or plan to hire support?

Is there anything else you'd like us to know about you or your vision?

Do you agree to uphold IPHI’s core values, professional standards, and brand integrity if accepted as a licensee?

I understand this application does not guarantee acceptance and may require a follow-up interview.

Please share any additional information you would like us to know.

IPHI Licensee Application Form