Approved New Membership Form

Approved Professional Membership Payment

Personal Information
Your Name(*)

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ARCH Membership Number

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Please Issue My Registration Certificate In

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Insurance Information
I have Renewed My PLI Through ARCH(*)

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For Scope 3 Professional Members Only
Insurance Information
I have Renewed My PLI Through Non-ARCH Third Party

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Date Insurance Will Expire (MM-DD-YYYY)

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Insurance Policy Number

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Name of Insurance Provider

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Note: If your PLI Insurance is not through ARCH Suggested Insurance, you must mail proof of Insurance to ARCH Office by July 31 or your membership will be considered terminated in accordance with the By-Laws of the Association.

All fees paid are not refundable.
Choose Level Of Membership You Were Approved For:

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Amount to be processed by Paypal

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If you are paying by cheque please skip the Paypal area and send an email to directormembership@archcanada.ca notifying them that payment will be sent by cheque to 6248 Main Street, Vancouver V5W 2V1
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 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 and contact my Insurance Provider for my PLI information.
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.
Comment/Questions/Up-Grades Request Section

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