Membership Application
To make application for membership to the IBTA, complete:
- Membership Application Form (see below or open as PDF)
- IBTA Ethical Standards Form (your typed name sent from your email will constitute your signature).
- Send a copy of completion certificate from your breathworker training (an email confirmation from your training program will suffice) and
- an Equivalency Form if you are certified by a non IBTA approved training program.
Forward #1 - #4 electronically, via fax or land mail to the IBTA Membership Coordinator
Jeremy Youst
Jeremy.ibta@gmail.com
45 Stones Mill Rd.
Spofford, NH 03462 USA
- Make payment via PayPal below or by US check or international money order.
You will be notified if your application is accepted (or if further verification is needed) and when your benefits will be forthcoming.
See the Membership Categories page and the Membership Benefits page for definintions of membership catagories below.
ONLINE CREDIT CARD PAYMENT
|
Student/Supporter ($75 per year) |
Individual Practitioner ($100 per year) |
Trainer ($150 per year) |
Breathwork Training Program ($200 per year) |
MEMBERSHIP APPLICATION FORM
| Breathwork School/Training Program . | Trainer . |
| Individual Practitioner . | Student/IBTA Supporter . |
Category 1:
..Supports IBTA principles and ethics
Category 2:
..Conforms to Form 2 training standards
Category 3:
..School/Training Program with reciprocity agreements
Name: Date: .
Address: .
City: State/Province: .
Country: .. Phone: .
Fax: .E-mail:
Website:
Fee enclosed:
$200 USD - Breathwork Training Program
$150 USD - Trainer
.
$100 USD - Individual Practitioner
.
$75 USD - Student/IBTA Supporter
.
Fee for current IBF members is $25 less for all Membership Categories.
Payment by US Check or International Money Order . (Payable to: International Breathwork Training Alliance)
Payment by PayPal ( www.paypal.com ): Use cgawlik@wi.rr.com
Application fee will be refunded minus administrative costs if membership requirements are not met.
Breathwork School/Training Program: (Documentation Form and Breathwork School/Training Program Agreement attached)....
Practitioners/Trainers-Trainings Completed: (Attach extra pages as needed)....
Years of training...... IBTA approved training: Yes.... No.... (Equivalency met)
Name of training(s)______________________________________________
Location_________________________________________________
Trainer(s)____________________________________________________
Dates__________________________ Hours___________________________
Attached copy of completion certificate from your training and Equivalency Form if not
IBTA approved____ To be sent____
Ethical Standards Agreement Form attached____ To be sent____
I affirm that the above information is accurate and that I commit to continued practice as a breathworker according to IBTA standards.
Signature__________________________________ Date______________
IBTA application form should be printed out, filled in and sent to:
International Breathwork Training Alliance
Jeremy Youst, Membership Coordinator
45 Stones Mill Rd.
Spofford, NH 03462 USA
International Breathwork Training Alliance
Ethical Standards Form
Given that an ethical code is essentially an agreement in good faith between a professional and the public she/he serves, I, (print name) ___________________________, as a professional breathworker do endorse the following standards and pledge to practice in adherence to them. At any time I am not in compliance with them I agree to voluntarily withdraw from professional practice and to return and rescind my membership in the International Breathwork Training Alliance.
Breathwork schools, trainers, practitioners and trainees in the International Breathwork Training Alliance agree to observe the following code of ethics. I agree to:
1. Client Suitability.
a) Establish a clientΉs ability to utilize and healthfully integrate breathwork, as far as is possible.
b) Not discriminate on the basis of race, ethnicity, gender, religion, sexual orientation, age or appearance.
2. Contract with Clients.
a) Establish clear contracts with clients regarding the number and duration of sessions and financial terms.
b) Establish clear boundaries and discuss the possible employment of touch.
c) Practice my breathwork skills primarily for the benefit of the client, rather than solely for financial gain.
d) Maintain confidentiality of client information and security of records of client session content.
3. Practitioner Competence
a) Practice within my area of professional competence, training and expertise, make this clear to my prospective clients, and not make claims for my service that cannot be substantiated.
b) Continue to develop personally, practicing the technique that I offer to others while nourishing passion and reverence for my calling, and keeping a healthy balance in my work and self care.
c) Seek supervision and consultation when appropriate.
4. Practitioner/Client Relationship
a) Establish and maintain healthy, appropriate and professional boundaries, respecting the rights and dignity of those I serve.
b) Refrain from using my influence to exploit or inappropriately exercise power over my clients.
c) Refrain from using my breathwork practice to promote my personal religious beliefs.
d) Refrain from all forms of sexual behavior or harassment with clients even when client initiates or invites such behavior.
e) Provide clients with information about community networking, educational resources and holistic lifestyle with their consent and within my scope of knowledge.
f) Refer clients to appropriate resources when they present issues beyond my scope of training.
5. Practitioner Interrelationships
a) Maintain and nurture healthy relationships to other breathworkers.
b) Give constructive feedback to other Alliance practitioners who I believe have failed to follow one or more of the ethical principles. If this does not sufficiently resolve the issue, seek consultation with the most appropriate professional and/or civil authorities within my local region for the protection of breathwork clients involved.
Signature________________________________Date______________
copyright by IBTA, 2005
