IFT Membership Application - Institute of Family Therapy

APPLICATION for MEMBERSHIP of the INSTITUTE OF FAMILY THERAPY

Contact Details - Step 1 of 9

Contact Information

Title *

Name: *

First

Last

Current Job Title: *

Email: *

Confirm Email

Mobile Phone: *

Address: *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

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Advanced Qualifying Level Training And / Or Registration With UKCP

When did you complete your advanced training? *

Name of organisation with whom you trained: *

Name of supervisor: *

Are you a member of UKCP? *

Which section?

Registration number

Date of initial registration

Do you want your UKCP membership to be renewed/managed by IFT?

Yes
No
Not sure*

*Please contact membership@ift.org.uk to discuss your options.

Has a formal complaint against you ever been upheld by UKCP? *

If yes, please give details

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Professional Qualification(s)

Layout - Professional Qualification

1. Professional Qualification *

2. Professional Qualification

3. Professional Qualification

1. Date Completed *

2. Date Completed

3. Date Completed

Membership Of Other Professional Organisations

Layout - Professional Organisation

1. Professional Organisation

2. Professional Organisation

3. Professional Organisation

1. Date of Registration

2. Date of Registration

3. Date of Registration

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Details Of Present Practice

Please give a brief summary of your present systemic practice. *

Supervision/Consultation

Name of supervisor *

Frequency of supervision/consultation *

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Continuing Professional Development (CPD)

Please give details of CPD for the last two years.

Layout

1. Title of Workshop *

2. Title of Workshop

3. Title of Workshop

4. Title of Workshop

5. Title of Workshop

1. Date of Workshop *

2. Date of Workshop

3. Date of Workshop

4. Date of Workshop

5. Date of Workshop

1. Organiser of Workshop *

2. Organiser of Workshop

3. Organiser of Workshop

4. Organiser of Workshop

5. Organiser of Workshop

1. Name of Presenter(s) *

2. Name of Presenter(s)

3. Name of Presenter(s)

4. Name of Presenter(s)

5. Name of Presenter(s)

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Publications

Layout (copy)

1. Title of Publication

2. Title of Publication

3. Title of Publication

4. Title of Publication

5. Title of Publication

1. Date of Publication

2. Date of Publication

3. Date of Publication

4. Date of Publication

5. Date of Publication

Research Experience

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References

Please supply two references in support of your application for membership.

One should be from a current member of the Institute of Family Therapy (and/or a UKCP registered family/ systemic therapist) and the other from someone who can comment on your current practice in the field of family/systemic psychotherapy.

The references should state the referees’ qualifications, current position, length of time they have known you and in what capacity, and their comments on your suitability for membership.

Please ask for their permission to provide a reference before supplying their details.

1. Name of Professional Referee: *

1. Referee Position Held: *

1. Referee Phone: *

1. Referee Email: *

2. Name of Professional Referee: *

2. Referee Position Held: *

2. Referee Phone: *

2. Referee Email: *

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Complaints

Have any formal complaints been made against you? *

Have there been any formal complaints made against you by clients in the last year? If yes, please indicate the nature of these complaints and their present status as to whether the complaints process has been completed or is still in progress. Please attach separate/typed details for the attention of the Director of IFT.

Please upload any supporting documentation for the complaint

Click or drag a file to this area to upload.

Have you been the subject of any disciplinary procedures? *

Have you been the subject of any disciplinary procedures by employers, professional bodies or any other agency (whether or not the process is completed) in the last year? If yes, please give details on a separate/typed sheet for the attention of the Director of IFT.

Please upload any supporting documentation for the disciplinary procedure

Click or drag a file to this area to upload.

c. Are you the subject of any outstanding/unresolved complaint/disciplinary procedures? *

Are you the subject of any outstanding/unresolved complaint/disciplinary procedures? If yes, please attach separate/typed details for the attention of the Director of IFT.

Please upload any supporting documentation for any unresolved matters

Click or drag a file to this area to upload.

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Declaration

On submitting this form there is an initial administration fee of £35.00.

If your application is successful, you will be invoiced separately for your yearly membership fee of £70.00 (valid end January to end January).

Membership of IFT entitles you to:

reduced fees at workshops and conferences
free attendance to evening seminars
use of library
advanced notification of teaching and clinical opportunities
opportunity to apply for UKCP registration via the IFT UKCP committee (if not already registered)
invitations to special members meetings
reduced rates for room bookings

I confirm that I am currently practising as a family / systemic psychotherapist.

I agree to abide by the Code of Ethics, Code of Practice and Membership Regulations of the Institute of Family Therapy (visit www.ift.org.uk /Quick Links/Policies) and undertake to inform the Membership Committee of the Institute should there be any complaints proven or outstanding against me which may contravene such Code of Ethics.

Signature: *

Date of Application: *

Membership Application Fee

Price: £ 35.00

Stripe Credit Card *

Card

Name on Card

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Family Therapy

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APPLICATION for MEMBERSHIP of the INSTITUTE OF FAMILY THERAPY

Contact Information

Advanced Qualifying Level Training And / Or Registration With UKCP

Professional Qualification(s)

Membership Of Other Professional Organisations

Details Of Present Practice

Supervision/Consultation

Continuing Professional Development (CPD)

Publications

Research Experience

References

Complaints

Declaration

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