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Membership Application

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Personal Information

First name

Last name

Email Address

Phone Number

Mailing Address

Qualification

Highest Level of Education

Bachelors

Masters

Doctorate

Post Doctorate

Others

In the field of:

Do you currently practice psychosexual therapy?

Yes

Licensure:

Psychologist

Marriage and Family Therapist

Professional Counselor

Social Worker

Others

Qualification

I certify that I am currently enrolled in an academic program at an accredited and recognized insinuation of higher education.

Where are you presently enrolled as a student?

What degree are you currently pursuing?

Bachelors

Masters

Doctorate

Post Doctorate

Others

Others, specify

Please upload proof of current enrollment

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Max: 2 MB

Attestation

Type Name

By checking this box and entering your name below, you affirm and warrant that you meet the qualifications necessary to apply for Certification as per the regulations set forth by the International Association of Psychosexual Therapists. You further affirm that you possess the requisite legal capacity to engage in clinical practice within your jurisdiction, adhering strictly to the laws and guidelines governing the practice of psychosexual therapy in your residing region.

Type Date

Type Name

By checking this box and entering your name below, you affirm and warrant that you meet the qualifications necessary to apply for Associate Membership as per the regulations set forth by the International Association of Psychosexual Therapists. You further affirm that you possess the requisite legal capacity to engage in clinical practice within your jurisdiction, adhering strictly to the laws and guidelines governing the practice of psychosexual therapy in your residing region.

Type Date

Type Name

By checking this box and entering your name below, you affirm and warrant that you meet the qualifications necessary to apply for Student Memberhsip as per the regulations set forth by the International Association of Psychosexual Therapists.

Type Date

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Your application has been received. Our administrative team will vet your submissions and get back to you in due time.

Thanks for your interest once again.

Documentation

Please upload your Letter of Intention

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Max: 2 MB

Have you read the IAPST Code of Ethics?

Yes

Do you agree to abide by the IAPST Code of Ethics?

Yes

Upload Letter #1

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Max: 2 MB

Please upload Two Letters of Recommendation from IAPST Certified Members.

Upload Letter #2

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Max: 2 MB

Please upload Documentation of Clinically Supervised Hours

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Max: 2 MB

Thank you for your interest in becoming a member of the International Association of Psychosexual Therapists. We are pleased to offer three types of membership: Certified, Associate and Student.

For detailed information concerning the requirements for each of these, please check out the specific membership page. If you are ready to apply, please select which type of membership you are applying for below.