Enrollment Form
School Policy
International Hypnotherapy Training Institute
Special Logistics: Student Consent Form Application
(877)690-6140 USA Toll Free
copy page and fax to: (877) 690-6140
Client Agreement: I understand that my sessions are for the purpose of learning and that my progress comes from my participation. I understand that if I am currently under medical or psychological care, it is in my best interest to contact my medical doctor and/or psychological practitioner and inform them of my choice to use these sessions. I understand sessions are to enable me to better understand myself, my relationships with other people and my environment. The consultant will make observations and suggestions to me, supply information, teach introspection and communication skills and offer
coaching on how to accomplish my personal and/or professional objectives. The consultant cannot and will not predict outcomes or make decisions for me. I assume full responsibility for my actions and inactions which relate to any sessions.
Client Release: I freely and voluntarily consent to undergoing sessions conducted by a I.H.T.I. staff member (“consultant"). I understand there are certain risks associated with these sessions, including but not limited to the following which I acknowledge the consultant hereby fully discloses: 1) sessions may bring to the conscious mind information and memories from the subconscious which may cause anxiety or strong feelings; 2) sessions may not be appropriate for those who have mental health disorders or are under the care of a mental health professional. I accept any and all risks for any adverse reaction I may have. I forever release International Hypnotherapy Training Institute., Martha Watson and any of their directors, officers, shareholders, employees, agents, sponsors, contractors, successors or assigns (collectively referred to as “IHTI”) from any and all claims for liability and damages of any kind whatsoever which I may at any time have, including without limitation personal injury, emotional distress and negligence (excluding only willful misconduct). I expressly waive all claims for indirect, consequential or exemplary damages. In no event shall I be entitled to recover more than the aggregate amount paid by me to IHTI. I will indemnify and hold IHTI harmless for any damages, including attorneys' fees, arising from my breach of the terms of this release. I have read and understand the contents of this release, I am 21 years of age or older and I execute this release of my own free will and without undue influence. I agree that the laws of the State of Pennsylvania will govern my relationship with IHTI.
School Policies
To receive your certification(s), complete each course successfully and abide by school policies. IHTI (International Hypnotherapy Training Institute.) Policies are deemed an attachment to IHTI Forms. Your payment or signature on any IHTI Form signifies that you read, understand and agree to the IHTI Policies.
Tuition: Course tuition includes materials cost. After reviewing and approving your application and order, and after checks and credit cards have cleared, IHTI will e-mail you your materials. A $20 fee is assessed on all returned checks; and if any payment is not able to be cashed or credited this may also result in immediate dismissal at IHTI's sole discretion.
Time Payments for Course Study: You agree to the following: If any one payment is not received and/or able to be cashed within10 days after the due date this may result in immediate dismissal and therefore the non-issuance of certification at the sole discretion of IHTI. Certificates are issued only after all payments are received in full and in a timely manner.
Advanced Standing Credit for Previous Study: If you are a graduate from another school and would like to advance your certification with IHTI, submit proof of prior studies such as previous certificates, transcripts or signed letters documenting the hours, material covered, dates and instructors' names. A IHTI staff member will need to approve your previous training hours. At the discretion of the IHTI Administration, prior training and/or experience may allow you to enter with credits and advance your certification with IHTI.
Prerequisites for Enrollment: A high school diploma, GED or equivalent, emotional maturity, high principles and a responsible attitude are required for enrollment. Prospective students may discuss personal, educational and occupational plans with IHTI staff prior to enrolling. Applicants for enrollment are required to be of 21 years and older.
Classes are in English.
Enrollments Accepted: Enrollments are accepted year round based on the land study and home study format. Home study Online interview enrollment application requires $100 registration fee (non-refundable). Land Training enrollment application registration fee is $200 (non-refundable) After completing the Enrollment Form,interview, submit payment for your tuition. Upon acceptance email validation, we will then forward the course material to you. We do not discriminate on the basis of race, sex, age, religious preference, national origin or marital status.
Non-Acceptance & Discontinuance: If IHTI does not accept your OnLine enrollment, registration interview fee of $100.00 is non-refundable. Land enrollment registration fee $200.00 is nonrefundable.
Attendance Requirements: All Attendance Requirements are to be attended with IHTI in a timely manner. Training requires 100 Attendance for consideration of certification, whether the audio format or campus lecture. OnLine attendance is validated by educational forum moderator. If you are unable to complete assignments within the stated time-frame, notify IHTI by e-mail, fax or letter of your desire for an extension. If IHTI finds your request to be satisfactory, it may grant a 30 day probationary period for you to complete the course assignments. Further extensions are at the sole discretion of IHTI.
Progress Requirements: IHTI's feedback system is designed to build self-confidence and competence. Exams (open-book) and student materials are graded under the Director's supervision. Students must participate 100% with each class either live or teleseminar and obtain a passing score of 75% to receive certification with IHTI. Students who fail to pass the exam may request to retake it one time. IHTI will then mail you a second exam which needs to be received by IHTI before the course assignment due date (or probationary due date if applicable). All other courses are graded pass/fail. After passing, your certificate (which is also notification of a passing grade) will be mailed to you directly from professional hypnotic member affiliation.
Private Tutoring: In any course, if you have difficulty, you may request tutoring at an additional cost at current rates.
Materials: Materials turned into IHTI become the property of IHTI. Please retain copies for your files if you would like them.
Transferability of Credits: Transferability of IHTI credits to any other educational institution is not guaranteed since that is up to the receiving institution.
Placement Assistance: IHTI does not promise or provide placement assistance to graduates; however, we will send a statement of your training, including CEU's, to a person, school or organization of your choice at base rate processing fee of $200.00 rates.
IHTI maintains school and student records for no more than 6 years, according to state law.All correspondence requests from students hold an administration rate charge.
Career Opportunities: IHTI does not make claims regarding future income since throughout the country the need for hypnotherapists varies. Those with good therapeutic and self-promotion skills usually have as much work as they target for themselves over a reasonable amount of time. Jobs in this area are generally self-created as small businesses; some choose to affiliate with health practitioners. As hypnotherapy becomes more accepted, more people will seek hypnotherapists. Income varies by region and time on the job and are established by the individual. Success in the field requires initiative.
Withdrawal Refund Policy: Home study-OnLine course materials, tuition is non refundable due to exclusive content of training material content.
Cancellation policy (Campus – land training):
If you cancel anytime after registering, but before the actual class date, you will be refunded 50% less $250 administration fee and cost of materials and the other 50% can be applied to a future class. No cancellations as of first day of class. Thank you for your understanding.
( IHTI policy to ensure quality of training has limited enrollment in land training).
Conduct & Dismissal: Participants are expected to conduct themselves professionally.
This includes, but is not limited to, complying with IHTI policies and paying tuition in full.
Failure to do so is cause for dismissal. Other causes for dismissal include, but are not limited to, any behavior which might jeopardize IHTI or its reputation; cheating; theft; verbal or physical abuse of any member of the IHTI community; breach of privacy or confidentiality. If a participant is dismissed, re-entrance into the program will be at the sole discretion of IHTI.
Grievance Procedure: If you have a concern, please speak with the IHTI director as soon as possible. If you feel it needs more resolution, submit your concerns in writing to the address listed herein. We will investigate your concern further, attempt to resolve it and notify you of IHTI's position on the situation within 30 days. If you wish to appeal this decision, you may make a written request for arbitration to be held in Erie, Pennsylvania, by a mutually agreed upon party. If circumstances preclude your ability to participate in an arbitration hearing, or if your complaint can not be resolved through arbitration, you may file a notarized complaint with the Erie Pennsylvania Department of Higher Education, Division of Private Occupational Schools no later than two years after the date you discontinued training.
Disclosure: In general, IHTI will not disclose information from student records without written consent of that student (which must include the information to be disclosed, the purpose for the disclosure, and the full name and address to which the disclosure is to be made). IHTI will, however, disclose information, without written consent, to: (1) Students or former students who wish to inspect and review their own records, upon receipt of
written request. (This is in compliance with the Family Educational Rights ad Privacy Act of 1974.) (2) Certifying bodies for purposes of certification. (3) Protect the health and well being of the student or other person. (4) An individual or organization which is sponsoring a student by paying for tuition in full directly to IHTI. (5) Those responsible for determining eligibility for financial aid or collection services after an application has been made. (6) Federal and state authorities as listed in the Family Educational Rights and
Privacy Act of 1974. (7) Comply with a judicial order/subpoena or other legal process.
Participant Release: In consideration of my participation in one or more services or courses of International Hypnotherapy Training Institute., and other business affiliation,Insight Therapies, the sufficiency of which consideration is hereby acknowledged, I forever release International Hypnotherapy Training Institute, Insight Therapies, Martha Amanda
Watson and any of their directors, officers, shareholders, employees, agents, sponsors,contractors, successors or assigns, (collectively referred to as “IHTI”) from any and all claims for liability and damages of any kind whatsoever which I may at any time have, including without limitation personal injury, emotional distress and negligence (excluding only willful misconduct). I expressly waive all claims for indirect, consequential or exemplary damages. In no event shall I be entitled to recover more than the aggregate amount paid by me to International Hypnotherapy Training Institute, Insight Therapies. I acknowledge I have been made no representation by IHTI as to my suitability for services or training, or as to any results which I may receive. I will indemnify and hold IHTI, Insight Therapies harmless for any damages, including attorneys' fees, arising from my
breach of the terms of this release. I have read and understand the contents of this release,and I execute this release of my own free will and without undue influence. I agree that the laws of the State of Pennsylvania will govern my relationship with IHTI.
Product Disclaimer: Opening the box and/or using materials constitutes your agreement
and acceptance of the following: These materials are for private instructional use only.Educational materials are unlawful to share with others.They are not a substitute for mental health advice. They are intended only for persons who understand and accept the risks of guided meditation, hypnotherapy, intuitive counseling,coaching (collectively referred to as “services”) including the risks described herein, and should not be used by any other person. The user assumes all risks and obligations, and agrees to indemnify and hold International Hypnotherapy Training Institute, Martha Amanda Watson and any of their directors, officers, shareholders, employees, agents, sponsors, contractors, successors or assigns (collectively referred to as “IHTI”) harmless for all claims and causes of action of whatever nature and origin, and the costs of defense
thereof, including actions by persons receiving services and third parties who allege harm resulting from such services. Risks include but are not limited to: 1) services may bring to the conscious mind information and memories from the subconscious which may cause anxiety or strong feelings; 2) services may not be appropriate for people who have mental health disorders or who are under the care of a mental health professional; and 3) techniques depicted in the materials should not be practiced or performed on any person who has not given his or her informed consent following full disclosure of the techniques
and risks. Do not use while driving. Contents are the copyrighted property of International Hypnotherapy Training Institute, Insight Therapies. All rights reserved.
Catalog -Web site Changes: International Hypnotherapy Training Institute, reserves the right to make changes in this web site and or catalog and forms including the right to change fees and policies. Such changes become effective at the time they are determined and apply to all participants. These changes may not apply to those currently enrolled in a program of study during their completion of that program.
Copyright: The contents of the audio, video and written materials, digital materials are the copyrighted property of the International Hypnotherapy Training Institute, Insight Therapies or persons or entities who licensed such audio, video and written materials for reproduction. Unlawful to share any use of material without written consent of IHTI director, Martha Watson. All rights are reserved by the owners of the copyrights. No portion may be duplicated or shared for viewing without written permission of Martha Watson. All rights reserved. No part of the material protected by this copyright may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, broadcasting, training classes, lending libraries, or by any information storage and retrieval system, without permission in writing from Martha Watson. All other trademarks referenced herein are the trademark, service mark or registered trademark of their respective holders. International Hypnotherapy All rights reserved Effective September 2007 © Copyright 1990 - 2008.
Facilities: IHTI administrative offices are located at 1358 West 30th Street Erie,Pennsylvania. • Phone (814) 866-2428 or (814) 504-7515 • Fax (877)690-6140• Toll Free USA (877)690-6140. Office hours are 9 A.M. to 5 P.M. (Eastern Time) Monday - Friday excluding holidays. IHTI, the facilities it occupies and the equipment it utilizes, fully complies with any and all federal, state and local ordinances and regulations, including those requirements as to fire safety, building safety and health.
IHTI Membership
Membership & Certification Policies: My signature signifies that I have fully and truthfully completed the application. I certify to The International Hypnotherapy Training Institute( IHTI) and Insight Therapies (IT) that I have completed the indicated hypnotherapy courses. I desire to become a member of IHTI and/or receive certification through IHTI, subject to the following terms and limitations. I agree to abide by the IHTI Guidelines for Professional Practice, as they may be adopted and as they may be amended.
In consideration of my membership in IHTI and/or certification through IHTI, the sufficiency of which consideration is hereby acknowledged, I hereby forever release IHTI, International Hypnotherapy Training Institute, Insight Therapies., Martha Amanda Watson and any of their directors, officers, shareholders, employees, agents, sponsors, contractors, successors or assigns, (collectively referred to as “IHTI”) from any and all claims for liability and damages for any kind whatsoever which I may at any time have, including without limitation personal injury, emotional distress and negligence (excluding only willful misconduct). I expressly waive all claims for indirect, consequential or exemplary damages. In no event shall I be entitled to recover more than the aggregate amount paid by me to IHTI. I will indemnify and hold IHTI harmless for any damages, including attorneys' fees, arising from my breach of the terms of this release. I have read and understand the contents of this release, and I execute this release of my own free will and without undue influence. I agree that the laws of the State of Pennsylvania will govern my relationship with IHTI.
PRIVACY STATEMENT: International Hypnotherapy Training Institute collects and uses your information
in accordance with our Privacy Statement, which can be viewed at www.International Hypnotherapy Training Institute.com
Student Signature Info
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Have you ever been hypnotized before?
Current occupation, website
Why are you interested in hypnotherapy training?
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Student Signature Date
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