Fillable Google Form to Register for the T’ai Chi Chih® Teacher Accreditation on Zoom with Daniel Pienciak
**********   November 11, 12, 13, 15 & 16, 18 & 19 2022 (Fri-Sat-Sun, Tues & Wed, Fri & Sat) **********

Led by Teacher Trainer, Daniel Pienciak
Hosted by April Leffler

In Your Own Home Via Zoom.
 
COST:  $525.  {$250 deposit to hold your space.  $275 balance due by October 14th.}

SCHOLARSHIPS may be available for up to $275 per person for Accreditations. The course host approves the scholarship request based on availability of funds. Please inquire about scholarship availability with the course host who will send you an application form.  

REGISTRATION: Please see the form below.  Please complete, and mail (if you're using snail mail) to the host with your deposit or full payment, to April Leffler; 702 Prospect Ave; Prospect Park, PA 19076.

Registration and Referral Forms are due at least 30 days prior to the course.  To assure your space, send in your deposit and registration form as early as possible.  If you are not able to get 2 signatures because the teachers feel that you are not yet ready, your deposit will be refunded in full if you cancel by October 14th.


   - The course is limited to 12 candidates.

   - Send your registration to reserve your space.

    - You do not need to send your Referral Form with early registration.

Auditing teachers will be considered if space is available. You must make a reservation with the online host, April Leffler at lirpaleff@rcn.com and fill out the registration form below. No payment for Auditing Teachers.



         ************    Register by October 14th.   Limited to 12 Teacher Candidates **********


REQUIREMENTS:  Please refer to the information on the website (www.taichichih.org) under “TEACHERS” and “ACCREDITATION”.  There are important requirements and the Guidelines/Referral Form that all candidates and their teachers will need including when you attended an Intensive who was the Teacher Trainer. Attending an Intensive is now mandatory prior to a Teacher Training as of 1-1-2021.


Signature Referral by Two Active, Accredited TCC Instructors:  When the two instructors are confident that you are ready to attend Teacher Accreditation, they will SIGN your referral form (available on the website above or from the course host).  The ORIGINAL signed form is to be sent to the Course trainer, Daniel Pienciak at P.O. Box 231; Bradley Beach, NJ 07720.  A COPY is to be sent to the Host (April Leffler).  This need not be sent with your registration form.  It can be sent in later, but your registration in the course is not complete until the Host receives it.
                                     
Accreditation is not guaranteed by the referral form nor by your attendance at the course.  Your accreditation certificate is awarded at the end of the course at the sole discretion of the Course Trainer. The Teacher Trainer will keep students apprised of their progress and readiness throughout the training.


LENGTH OF THE COURSE:  This course will begin Friday afternoon from 3:30PM-5:30PM, November 11th with the Zoom room opening at 3:00 PM. Saturday, Nov. 12, Sunday, Nov. 13th, Tuesday, Nov.15th, Wednesday, Nov. 16th & Friday, Nov. 18th will all be from 10:30 AM until 5:00 PM and Saturday, Nov.19th will be from 10:30AM-1:30PM  {{** We will NOT be meeting formally on the following days: Monday, Nov. 14 & Thursday, Nov. 17th **}} All times are Eastern Daylight Time. If you live in another time zone, we strongly encourage you to place a clock next to your computer with EDT on it to keep the time of the course clear.  Evenings provide time to work on your movements and presentation.  You MUST be able to attend all sessions in order to be accredited. There will be some free time after lunch.  *Schedule is subject to change*


This will be an online course using Zoom. You do not need a Zoom account, although it's a good idea so your settings get saved. You will receive an emailed link to click to join the sessions.  You can use a computer or tablet with a camera and microphone. It is very important that the Teacher Trainer will be able to see you onscreen from head to toe, which will put you back from the screen. The bigger the screen, the easier it will be for you to see. Having a connection between your device and a large screen TV or monitor is ideal and recommended. A separate camera can also help.

MEALS are up to you.  It is recommended that you plan meals ahead and either have them prepared in advance or simple to put together quickly.  
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First Name *
Last Name *
Name you prefer to be called (if different)
Cell Number
Address
City
State
Zip Code
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Your Primary Teacher (If you're a candidate)
Zoom setup
You can use a computer or tablet with a camera and microphone. It is very important that the Teacher Trainer will be able to see you onscreen from head to toe, which will put you back from the screen. The bigger the screen, the easier it will be for you to see. A connection between your device and a large screen TV or monitor is ideal and recommended.
I will likely be using for my zoom setup:
My experience using zoom is:
Tuition for the Accreditation is $525 per person: Payment in full is due by October 14, 2022. Scholarships of up to $275 may be available for those who need financial assistance. Contact April Leffler, lirpaleff@rcn.com or 610-809-7523 for Scholarship Application form. Use Venmo or mail checks to April Leffler, 702 Prospect Park, PA 19076,
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Next Steps - You will receive an email confirmation from Google (forms-receipts-noreply@google.com).  That email will allow you to edit your registration if needed. Then follow these instructions for payment (they will also be in the email).  If you prefer to not use Venmo, mail a check to: April Leffler, 702 Prospect Ave, Prospect Park, PA 19076.  Questions? Call, text or email lirpaleff@rcn.com / 610-809-7523
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