This form gathers additional information for NCBTMB submission. NCBTMB requires that certificates issued by DIRI are only for classes that are approved by NCBTMB.

This form is for Rolf Movement and Required Intermediate classes only. Elective credit classes are not eligible for NCBTMB approval through DIRI.

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If you are filling out this form for the first time, please click the New Submission button on the left.

If you are returning to edit or complete a previous submission, please fill out the email address and access code you set up previously and click Edit Submission.