(Please print off or hand write/copy this form)

Use this form to apply for a new membership or renew an expired one.

Fill out all parts applicable to your application.

Membership applies to the UK and surrounding Isles ONLY. Membership is not open to overseas. Application for membership is available to all therapists and unqualified/students. (Unqualified/students will receive student status on the register).

Yearly membership fee is £65. Please make Cheques/Postal Orders or Registered Cash payable to M Sherwood and send to our postal address below. Registered Cash payments ensure a faster (24 to 48 hour) application processing.

PLEASE WRITE CLEARLY & IN CAPITALS

Your Name ____________________________________________________________

Occupation ____________________________________________________________

Postal Home Address (Must be your home address and not work)

______________________________________________________________________

______________________________________________________________________

Post Code _________________________Telephone ___________________________

Mobile ___________________________ Work ________________________________

DOB ___________________________________

Qualifications (Use a separate piece of paper if needed) ________________________

______________________________________________________________________

______________________________________________________________________

A photo copy of at least one or more of your qualifications (certificates) must accompany this application form. Your application cannot be accepted without it. If in any doubt please telephone or email us first.

Once we receive your application we will email you with instructions on how to have your wording displayed on the register. Therefore please ensure that your email address is written CLEARY on this is form.

How did you find out about us? ________________________________

The exact name you want printed on your Membership Certificate

Name ____________________________________________________________

PLEASE WRITE EMAIL ADDRESS CLEARLY

Email address _________________________@__________________________

Please Note: Your email address MUST BE written CLEARY on this is form, as we will need to email you with instructions on how to have your wording displayed on the register.

Website http://www _________________________________________________

Terms & Conditions

Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date . . . . . . . . . . . . . . . . . Ref: SFTR 10.07

I fully understand, agree & sign to all of the SFTR Disclaimer/Terms & Conditions & Privacy Policy which I have fully read as displayed on the www.therapyregister.net website. I fully understand the SFTR reserves the right to refuse to accept/decline any applications for registration even after acceptance within the valid period at its discretion without offering any disclosure of reasons.


Comments____________________________________________________

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All cheques made payable to M Sherwood and sent to:
SFTR, 71 Thurlestone Rd, Office 2, Longbridge, Birmingham. B31 4LP

Telephone Number: 0121 680 0141 / 24hrs Answer

Mobile Number: 07796658169

Please allow 7 days - up to 14 days for your application to be processed.

Please check that all your contact details above are clear enough to read and that you have included the correct membership fee.

Thankyou for your application.

Copyright c 2003 - 2007 http://www.therapyregister.net - SFTR
Duplication is prohibited
All Rights Reserved
Ref: SFTR 10.07