Register An Account With Institute of Somatic Therapy

If you wish to take classes with the Institute of Somatic Therapy you are required to register an account. Registering an account will allow you to login and easily review your account. The information required below should be filled out using the information for the student who will be taking our online classes.

* Indicates a required field

Plese Enter Your First Name
Student First Name *
Student Middle Name
Please Enter Your Last Name
Student Last Name *
An Account Already Exists With This Email Address. If This Is Your Email Address You Can Use The Password Reset Utility By Clicking Here. Please Enter A Valid Email Address Please Make Sure Your Email Address And Your Email Address Confirm Are The Same
Email *
Confirm Email *
Please Enter Your Street Address
Street Address *
Street Address Cont'd
Please Enter Your City
City *
Please Enter Your State Or Province In The Field Below
State / Province *
Please Enter Your Country In The Field Below
Country *
Please Choose A Region From The Menu Below
Region *
Please Enter Your Zipcode
Zip Code *
Please Enter A Valid Phone Number
Phone Number *
- - Please Enter All Of Your State License Id Numbers
Licenses (Ctrl +Click To Choose ALL That Apply ) *

Input your license exactly as it appears, with all letters and numbers.

 

Please Enter A Password You Can Use To Log Into Your Account Your Password And Confirm Password Do Not Match
Password *
Confirm Password *
Please Tell Us How You Found Institute of Somatic Therapy
Where Did you Hear About Us *