Lumina Learning | Practitioner Application

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

* Please select your home region

Reference Code (if applicable)

Personal Information

* First Name

* Last Name

* Email Address

Secondary Email Address

* Primary Contact Number Country/Territory Code

* Primary Contact Number

Secondary Contact Number Country/Territory Code

Secondary Contact Number

Business Information

* Business Legal Name

Business Legal Number

* Country/Territory

Tax/VAT Number

Business Address

* Address Line 1

Address Line 2

Address Line 3

* Town

* County

* Postcode

* Country/Territory

Billing Address

Use the business address above for billing

* Address Line 1

Address Line 2

Address Line 3

* Town

* County

* Postcode

* Country/Territory

Locale Information

* Language

* Time Zone

Password

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.

* Password

* Confirm Password

Business Agreement

Please tick the box below to indicate that you have read and agree to the following:

Terms & Conditions

I agree

Personal Information and Privacy

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

Lumina Learning - More Details
- More Details

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

Please indicate that you acknowledge the following:

Practitioner Privacy Notice

I acknowledge

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