Counsellor Application

Registered Therapeutic Counsellor Application

If you have accumulated less than 1000 direct client contact hours and received less than 50 hours of supervision, please use this form to apply for our RTC designation.

If you have a minimum of 1000 direct client contact hours and have received a minimum of 50 hours of supervision and/or you have confirmation of senior or master level membership with another association, please apply for our MTC designation.

  Male
  Female

Important Information

Please allow up to 20 business days for the processing of your membership application. A non-refundable administration fee of $150 is required to review and process your application.

To help ACCT maintain the highest standard of membership, all applications go through a verification process. This ensures that ACCT helps set the quality standards for our profession and that ACCT members meet or exceed the requirement for their designation.

Privacy: Electronic copies of all documents will be kept in your secure file in accordance with our privacy policy.

Your Contact Details:

File Uploads

Please upload copies of your proof of liability insurance (or application) as well as supporting documents for your counselling or psychotherapy qualifications: diploma, certificate, degrees or transcription documents and references (instructions below). PLEASE BE SURE TO UPLOAD EVERY DOCUMENT THAT YOU WISH TO SEND TO ACCT. This is particularly important with references. Ask your referee to use the forms on this website. There is also a MISC Uploads Form for anything you forget! Thanks!

Provide Proof of Practical Experience

Please insure that you have provided either a transcript that indicates a completed practicum or a letter of reference indicating the completion of 150 hours of clinical practice with supervision as an integral part of your education, practicum experience, and/or paid or unpaid work experience in a counselling related capacity.

References

Provide two references from people who you have known for at least 1 year. One of your referees should be a mental health professional, with at least 5 years experience in their profession. The other should be in a counselling or education profession. If this is not possible please contact us.

 

Disclosure:

Expulsion from another professional body or having been the subject of a disciplinary review by another professional body or having a criminal record is not necessarily a bar to membership in ACCT. The failure to disclose all such information, or making a false declaration, may result in refusal or termination of membership.

Applications containing such disclosures will be submitted to a panel for consideration under the normal procedures outlined in Rules of the Association. Health matters that could affect your suitability for counselling will also be submitted to this panel for consideration.

It is important that you complete this section in full.

 

  Yes
  No
  Yes
  No
  Yes
  No
  Yes
  No
  Yes
  No
  Yes
  No

Disclosure: Additional information

If you have answered “Yes” to any of the above please provide a full and comprehensive statement, including details of the circumstances surrounding the disclosure, any mitigating factors and detail the steps you took to make any necessary changes in the box marked 'Additional Information'. Please address the experience fully and tell us what you have learned from your experiences.

Please list any unpardoned conviction and title it 'criminal conviction statement'. Some convictions are pardonable after a certain amount of time has elapsed.

All material information relating to your application must be disclosed under Additional Information (above). It is your responsibility to ensure that you declare all relevant information. If you are not sure whether something is relevant or material, please fill out the contact form and leave a phone number where someone can call you. Please ensure that your name and date of birth are exactly the same as on this application form.

 

  Yes
  No
  I understand that as a Member of the Association of Cooperative Counselling Therapists, I am an ACCT ambassador and I agree to uphold our values of competency-based counselling, cooperation, teamwork, equality, transparency, lifelong learning and financial accountability. I hereby sincerely pledge these ACCT values and my loyalty to my colleagues and co-owners in ACCT.
  I agree to practice under supervision for my first 1000 direct client contact hours.

Applicant Declaration and Signature

We ask that all applicants please read, understand and adhere to the ACCT Code of Ethics,  Standards of Practice and Philosophy and it is your responsibility as a member of ACCT to read the ACCT Rules. Please send us an email using the contact form with any questions you may have or leave a phone number and we will return your call.

Declaration

I confirm that the information contained in and uploaded with this form is true, accurate and complete. I hereby authorize the officers of ACCT to make such inquiries, as they consider necessary to verify the information given. I understand that any false or misleading statement or falsification of accompanying documents may lead to disciplinary action being taken against me and may result in immediate termination of my registration. I understand that failure to disclose on the application or during the period of membership could lead to disciplinary action and termination of registration.

 

  Yes
  No
  I have read and understood the above.
reload