ASTO Associate Application Form

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Instructions:
Applications must be complete before they are reviewed
Please read instructions carefully, and include all required documentation. Your application will automatically save. Changes can be made up until the application is submitted.

**The application form for Healthcare Affiliates is below this one**

1. Complete all pages of the application form in English.

2. Applicants must ensure submission of recommendation letters, transcripts and other relevant materials accompany this application to Registrar@bestco.info
3. The non-refundable application fee of $100 is required before the review process begins. Once your
application has been submitted with all required documents, instructions for payment will be emailed to you by the registrar.
4. You will receive a confirmation email from the Registrar within 5 days of receiving ALL of your application documents.

Email *

Checklist

A minimum requirement of a master's degree or equivalency. Attach an official transcript of your highest degree earned.

Documentation of membership in good standing from your professional credentialing body

Documentation of malpractice insurance coverage

Two letters of recommendation (at least one from a recent or current clinical supervisor)

Documentation of completion of one full credit, graduate level intensive sexuality course* Minimum of 35 hour course covering sexuality, sexual health and sex across the lifespan. *If you do not have a graduate course in sexuality, you are still eligible to become an associate member. This course is required before full certification, which generally takes 3 years once you are an associate member. *If you are uncertain if your sexuality course qualifies, please send the course outline to Registrar at: registrar@bestco.info

Documentation of completion of a Sexual Attitudes Reassessment (SAR)*Minimum of 14 hours. *If you do not have a SAR, you are still eligible to become an associate member. The SAR is required before full certification, which generally takes 3 years once you are an associate member.

Once your completed package is received by the Registrar you will receive an email from the Registrar within 5 days of applying to confirm receipt. You will be required to pay the application fee of $100 to Carlyle Jansen, Treasurer at astotreasurer@gmail.com. There are no refunds on application fees.

You are licensed to practice in Ontario.

Other:

Name: *

Preferred Pronouns *

Workplace Address: *

Telephone: *

Current Employer: *

Primary Designation *

Psychotherapist

Registered Marriage and Family Therapist

Social Worker (Master graduate)

Psychologist

Other. Registrar will assess if your degree meets equivalency requirements.

Required

Regulating College and Registration Number: *

Malpractice insurance carrier AND policy number AND date of renewal *

CAMFT Fellow? *

yes

Academic Experience

Highest Academic Degree Achieved. *

Department / Field *

Name of Accredited Institution *

Year Awarded *

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