Registration

Please fill in the form below

Alternatively, click here to download the registration form to complete offline.

Personal Information:

Title: *

First names: *

Surname: *

Nationality: *

Identity Number: *

Email: *

Language Preference: *

Employer:

Position:

Please indicate how you would like to receive your certificates:

Online Via Courier

Telephone Numbers:

Home:

Work:

Cell: *

Fax:

Address:

Residential Address: *

Postal Address: *

Town: *

Province: *

Town: *

Province: *

Category applied for (please select one):

Compulsory Assessment Fee - R140.00
This assessment fee MUST be paid in addition to the following registration fees.

Current members should scan in their membership certificate instead of a proof of payment of the evaluation fee.

If you are sure of your category, please select it below. Otherwise, our office will communicate to you your relevant category once the compulsory assessment is complete.

#	Category	Requirements	Cost
1	Specialist Counsellor	Masters / PhD Degree	R 840.00 annually
2	Counsellor	B / Honours Degree	R 780.00 annually
3	Institutional Counsellor	Certificate / Diploma	R 690.00 annually
3.1	Institutional Crisis Support	Certificate	R 690.00 annually
3.2	Institutional Trauma Support	Certificate	R 690.00 annually
3.3	TIR Facilitator	Certificate	R 650.00 annually
4	Counsellor in Training	In Training	R 650.00 annually
5	Practice assistant	In Training	R 360.00 annually
Assessment Fee		COMPULSORY	R 140.00

Relevant Documents:

Certified copy of ID / Passport *

Proof of residence *

Transcript *

Curriculum Vitae *

Testimonials

Qualifications

Please attach certified copies with each qualification.

Qualifications

Year From

Year To

University / Institution

Certified Document

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Training

Please indicate other relevant training and attach separate pages if needed.

Course

Date

Presented by

Applicable Document

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Experience

Please indicate other relevant experience and attach separate pages if needed.

Experience

Time From

Time To

Institution

Applicable Document

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Professional Registration

Please indicate other relevant registrations and attach separate pages if needed.

Name of institute

Date From

Date To

Applicable Document

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Offenses (Suspensions)

Suspensions from institutions

Institute

Reason

Date

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Offenses (Criminal)

Description

Sentence

Date

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