There are three requirements for MSK Track Instructor (TI):
1. Certification as MSK Independant Practitioner (IP)
2. A point for each Question #5,6,7
3. A reference from a Master Instructor in Question #8.

Applications are processed within 30 days.
Asterisk denotes required answer.

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* 1. Please enter the date.

Date

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* 2. Please enter your name.

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* 3. Please identify your profession:

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* 4. Please enter your IP number.

You must answer affirmative for each Question #5,6,7, in order to be certified as a MSK TI and proceed to the next question.

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* 5. Please confirm that: 
(1 point)

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* 6. Have you taught at a CPoCUS-accredited MSK course? Or taught at other non-CPoCUS- accredited courses? Please include course name and date.(1 point)

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* 7. Have you completed instructor training at a CPoCUS-accredited MSK course or instructed in a supervised setting ? Please list course name, date, and supervisor.
(1 point)

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* 8. Please provide a short reference from an MSK Master Instructor. (1 point)

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* 9. Attach additional material (if applicable).

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 10. Attach additional material (if applicable).

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 11. Attestation by applicant:

T