Apply For Approved School Status

Institution Information

Institution Name :
Owners Name:
Address :
Adress Line 2:
City:
Province/State:
Postal/Zip Code:
Country:
E-mail:

Telephone:

Main:
Cell:
Fax:
Institution Web Site:

Owner's Address (if different from above)

Address :
Address Line 2:
City:
Province/State:
Postal/Zip Code:
Country:
E-mail:

Telephone:

Work:
Cell:
Fax:

Owners Information

How did you hear about us?
List all related Associations you are a member of.
List all related certification held and from which organizations.
How long have you been involved in the field of Hypnotherapy?
Have you ever been convicted of a criminal act?
Please provide details if you answered yes to the above.
Have you ever had an application to a professional counseling and/or Hypnotherapy association (including IACH) rejected?
If Yes, please give details.

Institution Information
List the titles of the levels of Certification that you offer.

Level of Certification applying for.
Please give us a brief overview of what you offer in your training.
What are the main areas of focus in your training?
What is the average number of students who take your courses per year?
Is your institution registered in your particular geographical area with any government body and if so please provide details?
Is your institution registered as an approved school with any other associations?
If yes to the above please list which associations.
How long is your training(total hours)?
Please break down the number of hours required for each area of your training. (eg. class instruction, video,practice,etc.).
List all relevent criteria for a student to attain a particular level of certification in your institution.
List all required textbooks and manuals.
Comment or questions
I certify that the statements made by me in this application are complete to the best of my knowledge and belief.  In the event of any complaint or complaints arising which suggest unethical behavior on my part prior to or during the process of application for registration, I authorize the International Association of Counseling Hypnotherapists to both investigate and to consider such information as part of my eligibility for registration. I am aware that by checking this box it is equivalent to my signature.
I have read and understand Code of Ethical Conduct, and Standards of Clinical Practice for the International Association of Counseling Hypnotherapists. I am also aware that I am giving consent to the to the IACH to list my name,Company name, title, address, phone number,e-mail address, web site and area of specialty on the IACH web site which will be accessible to the general public if and when the IACH deems it appropriate unless I inform the IACH otherwise. I am aware that by checking this box it is equivalent to my signature.

Whenever possible, please scan, and e-mail all documents to @$ed#g*documents@hypnotherapyassociation.org@$ed#g*. Please include your name in the file name of each document. Send all files as gifs, jpegs or PDF.

Please note: This application will not be reviewed until payment is received. Please go to http://www.xe.com/ucc/ for currency conversion rate.

Application Fee (non-refundable) CAD$65.00(non-refundable) , Approved School Fee: CAD$130.00 , If paying by cheque please make cheque payable to: IACH, #1202 1255 Bidwell St. Vancouver, BC Canada V6G 2K8