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Membership Application (short).

All fiields are mandatory
Click Here for a PDF file about Membership Requirements.

Your name:

    Address: Telephone:

What grade of membership are you applying for?

When did you graduate?
How many sessions monthly do you conduct (about)
Supervisor's details
Type of Supervision: Differential Peer
When started:
Supervision frequency and length:

Main modality: Face to Face Telephone Other (please specify):
Please note: Supervision details are subject to a random checking procedure

Registration details (enter '1' where not registered):
CNHC registration number:
BACP registration number:
UKCP registration number:

Continual Professional Development:
There is a requirement for a minimum of 15 hours CPD per year (If you are a CPD provider, this is accepted)
Please list trainings attended in the last 12 months (subject to random checking)
DECLARATION (subject to randomised checks)

I have professional indemnity insurance; my certificate number is:
I know of no legal or other reasons why I should not be offered membership.
Signed: This typed signature signifies that you confirm all details on this form are correct to the best of your knowledge. Where this name does not match that at the top of the form, the application will not be processed.