RPE Apprentice – Notice of Intent

Welcome to the American Polarity Therapy Association (APTA) process of becoming a Registered Polarity Educator (RPE).

The first step is to complete and submit this Notice of Intent to train as an RPE Apprentice with an Approved Training Manager (ATM) Mentor.

By completing this you agree to follow the APTA RPE Standards for Education and Code of Ethics.

Once this form is submitted and confirmed with the ATM Mentor, you will receive the RPE Apprentice Packet with all the information you need to complete your training.

First Name *

Last Name *

Telephone *

Email Address *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country

RPP Level of Education Details

Please provide the details of where you received your education.

School Name *

Date Graduated *

ATM Mentor Information

Please provide the ATM Mentor's contact details

ATM First Name *

ATM Last Name *

ATM Telephone *

ATM Email Address *

Membership and Intent Details

I am currently a member of APTA *RPP with BCPP in ProcessBCPP

Apprenticeship Start Date *

Education Level you intend to teach *APPRPPBoth APP & RPP

Registered Polarity Educator (RPE) Apprentice Notice of Intent

RPP Level of Education Details

Please provide the details of where you received your education.

ATM Mentor Information

Please provide the ATM Mentor's contact details

Membership and Intent Details