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Application form for membership of the Society for Holistic Therapists and Coaches This form should be printed, and returned to the Society with your signature and copies of relevent qualification and insurance forms. Successful applicants will be sent their membership certificate if they have enclosed insurance documentation. Uninsured applicants will be initially sent a professional membership letter confirming membership at the appropriate grade subject to insurance within 28 days. This can be used in insurance applications. On receipt of insurance documentation a membership certificate can then be issued to the member. First Name(s)................................................................................................................. Surname........................................................................... Initials ................................... Date of Birth ....................................... Gender .................... Title ................................. Address (not published online or shared externally) ........................................................................................................................................ ............................................................... Tel ............................ Fax .............................. Mobile ............................... Email................................... Website ................................... Profession / Job Title: (Student, Therapist, Healer etc) ....................................................... ......................................................................................................................................... Areas of competence: ( Therapy area, qualification, level , awarding body) .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... Additional areas of experience ........................................................................................................................................... ........................................................................................................................................... ........................................................................................................................................... ........................................................................................................................................... Years of professional experience, attaching evidence in the form of copies of professional registration certicates or insurance documents for that time period. ............................................................................................................................................ Years since completing qualifications accredited by a QCA / SQA approved awarding body / Degree / NVQ / SNVQ. ............................................................................................................................................. You must attach copies of your accredited award (unless applying via your awarding body / accredited training centre, in which case ensure the following section in italics is completed by that training body). Award name............................................... Accredited body .............................................. College Stamp ............................................ Date of Award ................................................ Contact details for college tutor / principle for verification. ..................................................... ............................................................................................................................................. ............................................................................................................................................. College name, and accredited centre number / details ............................................................ ............................................................................................................................................. Level of membership being applied for: Student / Associate / Full (delete as appropriate) Student members: Anyone currently on or beginning a suitably accredited course. Associate members of the SHTC (ASHTC) have Level 3 awards, and are offered additional support to ensure competent service provision. Full members of the SHTC (MSHTC) have Level 4 or 5 awards or appropriate degrees, or have Level 3 awards with five years of post qualification experience. Fellowships are only awarded to existing members who meet additional criteria. ..................................................................................................................................................... Other professional bodies or memberships: ..................................................................................................................................................... ...................................................................................................................................................... If you wish you may provide details of any disabilities or additional needs that you have, that we may be able to support you with. This information will not be shared with any outside agency, and will be used only by the Society. This information is only used in order to ensure appropriate support for you. If you prefer, the disabilities officer can contact you for an informal discussion instead of providing details below. ....................................................................................................................................................... ....................................................................................................................................................... Would you like to be contacted by our disabilities officer to discuss the above, or simply to enable support when you need it? Yes / No (delete as appropriate) Declaration, please read carefully and keep a copy of this application for your records. In applying for membership to the Society for Holistic Therapists and Coaches I (the applicant) agree to adhere to the code of ethics and the National Occupational Standards for the therapy or therapies I offer. I also agree to be subject to the disciplinary procedure of the Society. I understand that only Fellows, Advisory Board members and Emeritus Fellows have voting rights, although from time to time the Society may canvess my opinion in regard to descision making. I understand that I must maintain professional insurance at an appropriate level, and must inform the Society in writing if there is any complaint against me or claim on my insurance policy. In applying for membership I agree to disclose any previous complaint against me (as defined in the complaints procedure) and any criminal convictions as follows:
We will absolutely respect your right of confidence, and will not discriminate against ex offenders under the rehabilitation of offenders act, except where other legislation such as the Childrens Act require us to refuse membership. In applying for membership I also testify that I am of sufficiently sound (or appropriately managed) health mentally, physically and spiritually as to not to pose a threat or risk to clients as defined in the appropriate sections of the National Occupations Standards for the appropriate therapy / therapies. We actively support and encourage members who have disabilities and or special / additional needs in their professional practice and do not discriminate against people with such restrictions. I understand that I am liable for my own adherence to UK Law in regard to ongoing legislation, taxation, keeping of taxation records, trading and advertising standards and other applicable laws and rules. Signed: (applicant).......................................................... Date......................................... You are advised to take a copy of this document before mailing. You are also advised to send your application using a certificate of posting (free of charge) or by registered / recorded post. Please enclose the appropriate membership fee with your application. Post to: Society Holistic Therapists & Coaches A downloadable "MS-WORD" format file is available to download HERE (right-click and select "save"). |