Application for eeai membership
eeai membership is for professionally accredited practitioners actively offering counselling, psychotherapeutic or psychological services to clients informed and guided by an ecopsychological and/or ecotherapeutic approach. After confirming your eligibility, please fill out the professional membership application form below. Your request for membership will be reviewed with a response issued in a timely manner.
Email address *
First Name *
Your answer
Surname *
Your answer
Your practice
eeai members are professionally accredited practitioners, eg. Counsellors, Psychotherapists and Psychologists. Following eeai membership approval your practice details will be advertised on the eeai website. (Unless you choose the membership only option.)
Your profession *
Your answer
Your practice name (if applicable)
Your answer
Your practice location *
Your answer
Your practice website URL (If relevant)
Your answer
Your practice phone number (If relevant)
Your answer
Your short bio written in the 3rd person (22 words max)
Your answer
Accreditation requirements
Applicants are required to hold professional accreditation from a valid accreditation body. Applicants with ‘pre-accreditation status’ are permitted to apply for eeai membership. Students with ‘student accreditation’ are welcome to join the eeai community as a subscriber until they have pre-accreditation status.
Your accreditation body(s) *
Your answer
Is your accreditation active at present? *
Ecopsychology & Ecotherapy
eeai is guided by its values, ethos and aims/mission statement and constitution available at http://eeai.ie/structure/
Have you read and do you accept the ethos, aims/mission statement, core values and constitution of the eeai? *
Are you currently actively offering counselling, psychotherapeutic or psychological services to clients informed and guided by an ecopsychological and/or ecotherapeutic approach? *
Do you accept that if any of the above details of which you have furnished change that it is your duty and responsibility to let the eeai know of such changes? *
Annual membership fees for 2018/19
Membership fees are due on 1st of March each year. Should your application be approved after 1st of April, your fee will be calculated accordingly. Following receipt of your membership application approval you will be issued a request to make a secure payment via PayPal for your membership fee due. All major credit, debit, visa & mastercards are accepted.
Please choose from the options below *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms