1. Which of your contact details would you like listed in the AHHCA Practitioner Locality Guide?
2. I hereby apply for the following membership with the Australian Holistic Healers & Counsellors Association:
3. ACADEMIC BACKGROUND / CURRENT STUDIES
4. PRACTICE DETAILS
If you answered yes, please supply insurance certificate of currency.
If you answered no, would you like information on obtaining insurance?
Yes No, I will source my own insurance
No, I am not currently practising.
Please note that if you are practising, your AHHCA membership will only be valid if you have current insurance.
5. Please supply a copy of your driverís license and references as indicated below.
6. DECLARATION: I SOLEMNLY AND SINCERELY DECLARE THAT:
I MAKE THIS SOLEMN DECLARATION, CONSCIOUSLY BELIEVING SAME TO BE TRUE AND BY VIRTUE OF THE PROVISIONS OF THE OATHS ACT OF 1900 Ė 1935 SUBSCRIBED AND DECLARED AT