AACT LICENSING FORM

Application for Membership in the American Association of Christian Therapists

Application Deadline - March 19, 2024
All applicants are to apply using the application presented below. Be sure to read each section thoroughly. THIS APPLICATION IS TO BE SUBMITTED along with the licensing fee using the tab below the application.

You will be asked for documentation to support the data you provided. Likewise, all correspondence and agreements will be generated from the personal information submitted below. So, please use proper spelling, capitalization, and punctuation.
Yes, I have
I. Personal Data:

Tell us about yourself
Full Name*

First NameLast Name
Birthdate:*

MonthDayYear
Mobile No. :*

Area CodePhone Number
E-mail :*
Where the confirmation will be send to
Home Address :*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
MaleFemale
YesNo
HispanicNon-HispanicNot Indicated
WhiteBlack or African AmericanAsianAmerican Indian or Alaskan Native Hawaiian or Other Pacific IslanderNon-Resident Alien
VeteranChild of a VeteranGrandchild of a VeteranSpouse of a VeteranNone of the Above
I am an expectant graduate of a theological, religious studies, biblical psychology or philosophy program.I am a returning member of AACT
Yes, I am a graduate of a theological, religious studies, biblical psychology or philosophy program.No, I have not completed a theological, religious studies, biblical psychology or philosophy program. .
If YES, Select the Degree Received:
Please indicate what is your major are of study
What is your Ministry Objective in this field of study:*

0/300
YesNo
II. Other Information:
YesNo
YesNo
YesNo
Why have you applied for membership in AACT?*
List the name, address and phone number of one ministry reference:*
List the name, address and phone number of one personal reference:*
List the name, address and phone number of one business reference:*
YesNo
Are you currently licensed through your state in any particular field or profession. If so, list license title and agency. *
III. AACT Doctrinal Statement (Philosophy):
WE BELIEVE THAT...
- The Bible is our sole guide and is the inspired, infallible, authoritative Word of God.
- Divine inspiration extends equally and fully to all parts of the writings in the original manuscripts and is therefore without error.
- All scriptures were designed for practical instruction in our everyday living.
WE BELIEVE IN THE...
- Deity of our Lord Christ and that all Scriptures center around Him. We believe in His virgin birth, sinless life, miracles, vicarious atonement on the cross, bodily resurrection, ascension to the right hand of the Father, and in His personal return in power and glory.
- New Birth of the believer, in the salvation of lost and sinful people through personal repentance, and in regeneration by the Holy Spirit.
- Present ministry of the Holy Spirit by whose indwelling the believer is able to live a godly life.
- Resurrection of both the saved and the lost: of them that are saved into the resurrection of life, of them that are lost unto the resurrection of damnation.
YesNo
IV. Statement of Ethics:
As a member of the American Association of Chrisitan Therapists, I PROMISE to conduct myself at all times in an ethical manner becoming to my title. I shall not be self-serving or monopolizing or take undue advantage of any person that I choose to offer my services.
1. I PROMISE to strive for excellence in my counseling. Whenever possible, I will continue to advance my learning and improve my counseling skills through continuing education.
2. I PROMISE to be fair in all my practices and with those, I seek to help. When any act or practice of mine has been challenged by a client or the ACCT, I shall endeavor to respond and help to solve the problem in a timely manner.
3. I PROMISE to counsel only within the boundaries of my training and experience. I will not intentionally jeopardize the well-being of any client by using any approach or practice when I am not trained properly or qualified ina specific discipline or modality. I will take the responsibility to refer a client to another therapist if I feel unqualified to help them.
YesNo
V. REQUEST FOR CRIMINAL RECORDS CHECK AND AUTHORIZATION :
I hereby request Choice Point/Volunteer Select to release any information which pertains to any record of convictions contained in its files or in any criminal files maintained on me whether local, state, or national. I hereby release Choice Point/Volunteer Select from any and all liability resulting from such disclosure.
YesNo
If YES, please list the city, state and the nature of the offense :
Upload a copy of your completed dissertation in a pdf or word document file. Click the link below
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VIII. Applicant's E-Signature
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature:*
Should be Empty:

Application for Membership in the American Association of Christian Therapists

I. Personal Data:

II. Other Information:

III. AACT Doctrinal Statement (Philosophy):

IV. Statement of Ethics:

V. REQUEST FOR CRIMINAL RECORDS CHECK AND AUTHORIZATION :

VIII. Applicant's E-Signature