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New Membership Application Form (for Non-ARCH Accredited Training Applicants applying for ARCH Professional Membership)
Personal Information
First Name(*)

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Last Name

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Username(*)

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Address(*)

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City(*)

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Select Province(*)

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Postal Code(*)

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Home Phone(*)

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Email(*)

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Password(*)

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Your Date of Birth (follow hyphen format) (MM-DD-YYYY)(*)

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Training Information
Name of Training Institute or School(*)

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Location(*)

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Phone(*)

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Total Hours of Training(*)

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Designation Acquired or Level of Certification(*)

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Total Hours of Supervised Practicum(*)

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Was the training by extension/home study?(*)

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Was the training by accelerated or intensive study?(*)

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Start Date (MM-DD-YYYY)

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Completion Date (MM-DD-YYYY)

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Additional Comments

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Note! You will be required to pass a written competency exam if non-accredited ARCH Training. The competency exam may be waived at the discretion of the Director of Membership.Invalid Input
Professional Liability Insurance (PLI) and Commercial General Liability Insurance (CGL) is a mandatory requirement for all professional level members of ARCH Canada. ARCH Canada has group insurance for members that is recommended. Once competency exam is successfully completed, you will be forwarded the PLI/CGL insurance application. Invalid Input
All Professional Level Members (RHt/RHP, RCH/RCHP, RCCH/RCCHP) must undergo and provide a current Criminal Records Check (CRC) conducted by the police/RCMP in their local area. The cost of the CRC is the responsibility of the applicant. The CRC must include Vulnerable Sector Check.Invalid Input

For Professional Level Membership Only – Practice Information
NOTE: The Following Information Will Be Listed on the ARCH Website.
Please ensure you have checked the information carefully as this will show as your listing on the website.
Name of Practice(*)

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Business Phone Number(*)

Phone Number Format (000-000-0000)
Business Fax (optional)

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Business email address(*)

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City(*)

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Province for Practice

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Business Website URL

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Other Areas of Certification (initials only)

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Professional Associations
Membership in Other Association/s

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Date Joined

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Membership Number

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Are you a member in "Good Standing?"

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Has your Professional Membership been suspended/terminated in the past 5 years?

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You will be charged a non-refundable $25.00 application fee
Choose Level Of Membership You Are Applying For:

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Amount to be processed by PayPal

0.00 CAD
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.
I understand that once the membership dues are processed that they are non-refundable.
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.
I agree to and understand that non-compliance to the above will render my membership invalid without recourse.
Signature(*)

By checking this box you are digitally signing this application and confirming the information in this application to be true.Please check box to confirm the information in this application is true.
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