Application for Level 4 - Buteyko Breathing Educators Association

Date*

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Best contact telephone*

Email*

Enter Email Confirm Email

Business Name

Current Occupation

Select one:*

If you have never belonged to the BBEA before, please also complete the application for membership (https://buteykoeducators.org/register/)

I am a current BBEA member
I am a returning BBEA member
I am not a BBEA member, but am applying

List any Degrees/Certifications not mentioned in previous documentation. (Attach copies of diploma etc)

Degree/Certification copies

Any declared degree or certification must be accompanied by a copy of the degree or certification.

Drop files here or

Max. file size: 256 MB.

How many clients/patients have you taught?*

You may be asked to support this number with documentation.

Please enter a number from 0 to 999999.

How many case studies have you completed?*

If your trainer did not require case studies, you may be asked to write up case studies from your client/patient records. If you have written papers or presented cases at a conference or webinar, those count as completed case studies.

Do you have at least 14 BBEA CE units in the last 2 years?

If you are a new member, this is not a requirement.

Yes
No
I am a new applicant for membership

Papers/Webinars:

Please list any publications you have authored, and any webinars you have presented. Indicate case studies.

How many Buteyko webinars/conferences have you attended?*

If you are a new member applicant, enter N/A

How many webinars have you presented?*

If you are a new member applicant, enter N/A

Have you presented at a conference?*

If you are a new member applicant, we understand it may not be a BBEA conference

Yes
No

When and where?

Have you done YouTube videos or TED talks? Please itemize.