1. New Membership Application Form (for Non-ARCH Accredited Training Applicants applying for ARCH Professional Membership)
  2. Personal Information
  3. First Name(*)
    Please Enter Name
  4. Last Name
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  5. Username(*)
    Username Already Registered or Enter Valid Username
  6. Address(*)
    Please Enter Address
  7. City(*)
    Please Enter City
  8. Select Province(*)
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  9. Postal Code(*)
    Please Enter Postal Code
  10. Home Phone(*)
    Phone Number Format (000-000-0000)
  11. Email(*)
    Email id already exists or Enter Valid Email Address
  12. Verify Email(*)
    Emails Ids do not match
  13. Password(*)
    Please Enter Password
  14. Verify Password(*)
    Password Not Match
  15. Your Date of Birth (follow hyphen format) (MM-DD-YYYY)(*)
    Please enter DOB
  1. Training Information
  2. Name of Training Institute or School(*)
    Please Enter Institute Name
  3. Location(*)
    Please Enter Location
  4. Phone(*)
    Phone Number Format (000-000-0000)
  5. Total Hours of Training(*)
    Please Enter Hours
  6. Designation Acquired or Level of Certification(*)
    Please Enter Designation
  7. Total Hours of Supervised Practicum(*)
    Please Enter Hours
  8. Was the training by extension/home study?(*)
    Please select atleast one field
  9. Was the training by accelerated or intensive study?(*)
    Please select atleast one field
  10. Start Date (MM-DD-YYYY)
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  11. Completion Date (MM-DD-YYYY)
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  12. Additional Comments
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  1. For Professional Level Membership Only – Practice Information
  2. NOTE: The Following Information Will Be Listed on the ARCH Website.
  3. Please ensure you have checked the information carefully as this will show as your listing on the website.
  4. Name of Practice(*)
    Please Enter Name
  5. Business Phone Number(*)
    Phone Number Format (000-000-0000)
  6. Business Fax (optional)
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  7. Business email address(*)
    Please Enter Valid Email Address
  8. City(*)
    Please Enter City
  9. Province for Practice
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  10. Business Website URL
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  11. Other Areas of Certification (initials only)
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  1. Professional Associations
  2. Membership in Other Association/s
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  3. Date Joined
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  4. Membership Number
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  5. Are you a member in "Good Standing?"
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  6. Has your Professional Membership been suspended/terminated in the past 5 years?
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  7. You will be charged a non-refundable $25.00 application fee
  8. Choose Level Of Membership You Are Applying For:
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  9. Amount to be processed by PayPal
    0.00 CAD
  10. I declare that I have not been convicted of any Criminal Violation that would preclude me from practice as a Hypnotherapist and remove me from "Good Standing" with ARCH.

    I understand that my professional membership level is valid only if I carry Professional Liability Insurance and Commercial General Liability Insurance that is current and active.

    I give permission to ARCH to list my Name, Name & Location of my Practice/Employer, Client Contact Phone Number, Business Email & Business Website on the ARCH Website unless otherwise stated.

    I understand that all information in this application, along with subsequent information is placed in my membership records and will be used for purposes of admission, registration, research, alumni and development, and other purposes consistent with the mandate of ARCH. The use of this information will be in compliance with the Freedom of Information and Protection of the Privacy Act of Canada. Any question concerning the collection and use of this information should be directed to the Director of Membership.

  11. I understand that once the membership dues are processed that they are non-refundable.
  12. By submitting this application, I declare that I have read, and am in complete agreement with the Code of Ethics and Standards of Practice of ARCH and support the Goals and Objectives and Mission of the Association.
  13. I agree to and understand that non-compliance to the above will render my membership invalid without recourse.
  14. Signature(*)
    Please check box to confirm the information in this application is true.
  15. (*)

    Fill this box
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