Practitioner Application Form

To apply to become a Lumina Learning Practitioner, please complete the form below.

Only complete this form when asked to do so by your Lumina Learning Partner.

To speak to us about our products and solutions or about becoming a Practitioner, please get in touch here .

Fields marked with a * are required for registration.

Your Home Region

Personal Information

Business Information

Business Address

Billing Address

Locale Information


Please enter a password below. You will only need this password if you do not already have a Lumina Account that you use to sign in.

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.

You will be contacted by your Lumina Learning Partner when your application has been processed.