Premium Profile Entry Form

Thank you for joining the LMA Practitioner Directory!  Please fill out the following form. Once you have sent your information, please purchase your premium membership (good for one year) through google checkout. Once payment clears, your data should be added to our database within 5 business days.

Your name as you would like to appear online: (required)

Your email: (required)

Please list your certification, college, and any other credentials:

Current location (State or Country):

What services do you offer? (Movement therapy, observation, coaching, workshops, teaching, residencies, etc.)

Website (if applicable):

Bio (limit 300 words):

Please list your phone number (optional) and the email address you would like messages sent to:

Please upload an image for your profile (landscape orientation works best)

By submitting this information, I give Movement Has Meaning ("MHM") permission to publish the information I have provided. If requested, I agree to show proof of certification either through a copy of my certificate or through two references. To the best of my knowledge, all information provided is accurate and up to date. I understand and agree MHM is not liable for any harm or liability resulting from this listing, and they have full authority to revoke my membership in this directory without refund if my professionalism or certification is in question.

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