Association of Cooperative Counselling Therapists of Canada

Application Forms

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Student Application

Join us and help create the future of counselling in Canada!

Requirements to be eligible to apply for Student Membership with ACCT:

Student applicants must be currently registered in an applied counselling training program or equivalent with a minimum of 6 months remaining in their program until graduation. Student members must not practice counselling, except when supervised and as part of their training and/or practicum completion. Student members must purchase a membership share.

Student members do not qualify for liability insurance under the ACCT group plan.

Prior to beginning the online application process, it is important to ensure that all required documents are scanned and saved to your computer.

Application costs:

ACCT Membership Share - $100.00 one-time payment (refundable on request when you discontinue your membership).
Student Fee - $70.00 - credited towards your approved Registered Therapeutic Counsellor (RTC) designation.

ACCT Student Required Documents:

A copy of current resume.
A copy of proof of enrollment in your current counselling education program.

Your Personal Information:

* First

Middle

* Last

* Date of Birth DD/MM/YYYY

* Gender

* Have you ever used any other name(s) Yes/No/If other, please list name(s) used (This is important if your uploaded documents are in a different name.)

Your Contact Details:

* Address

* City

* Province

* Postal Code

* Country

Cell Phone

* Work/Home Phone

* Email

Website

School Information

Please upload proof of enrollment and answer these few questions about your school.

* Name of School

* Name of Program

* Expected Year of Completion

* File uploads: Resume

* Proof of Enrollment Please upload a letter from your school confirming registration in an applied counselling program including the program start and completion date.

If you have anything else you wish to upload, please do that here

Additional information

* Newsletter Opt In I consent to receive newsletters, counselling news and updates, announcements, event invitations, and other electronic messages, which may contain promotions regarding ACCT news, upcoming PD offerings, ACCT community events, our annual AGM etc.

Yes
No

* Practicing/Logo Use

I am aware that ACCT Student members must not practice counselling, except when supervised and as part of their training and/or practicum completion. Further, that ACCT restricts the use of the ACCT Badge or Logo to those members with designations.

* Pledge

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.

Applicant Declaration and Signature

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, falsification of accompanying evidence may lead to disciplinary action being taken against me and may result in immediate termination of my membership. I understand that failure to disclose on application or during the period of membership could lead to disciplinary action and termination of membership.

Payment for Membership Share and Professional Fees do not guarantee acceptance. If you are not accepted, your payment will be refunded minus the processing fee. You must purchase a $100 Membership Share in ACCT in order to be considered for professional membership and this $100 is refundable if you discontinue your membership.

* Date DD/MM/YYYY

* Applicant's Signature By typing your name in the box above you solemnly agree that the contents of this application form are true and that your typed name represents your personal signature.