New Practitioner Application Form

To apply for a Lumina Learning Practitioner account please complete the form below.

Fields marked with a * are required for registration.

Your Home Region

Personal Information

Business Address

Tax Details

Billing Address

Locale Information

Account Password

Please enter a password below, this will be used to setup your initial account. You will be notified by a Lumina Learning Partner when your account becomes active.

Business Agreement

Personal Information and Privacy

By enrolling to become a Practitioner you share some of your personal information with:

The personal information you share as a Practitioner is processed in accordance with the Practitioner Privacy Notice.

I acknowledge