Application Form for LMFTs and AAMFT Members

Application Form for LMFTs and AAMFT Members
Preferred Prefix
Preferred Pro-Noun
Legal First Name*
Preferred First Name
Middle Name or Initial
Legal Last Name *
Work Phone #
Home or Cell #
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
Please use the email address that you want CACFT to contact you at.
1. What is your Degree? Please provide full name and abbreviation. This should be the degree that qualifies you to become an LMFT or AAMFT Clinical Fellow or Pre-Clinical Fellow.*
Please upload a document that shows your degree. eg Diploma, transcript.

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2. Please upload a copy of your LMFT license OR an AAMFT document that shows your membership status.

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If you have uploaded an AAMFT document that shows you are a Professional Member, please include a document that shows you are a clinical fellow with AAMFT if you are applying to be an RMFT with CACFT. Otherwise, you will be grand-parented in as an Associate member.

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3. I understand that RMFTs must complete 16 hours of continuing education. Information about what CEUs are acceptable can be found on this link.https://camft.ca/Continuing-Education-for-RMFTs/

Yes
4. Ethics. Has your registration, certification or license to practice in the health care industry ever been suspended, revoked, restricted or denied, or has any other disciplinary action been taken against you by any provincial, federal or state, regulatory body or foreign jurisdiction, or are you presently under investigation by any regulatory body or professional association to the best of your knowledge?*

YesNo
All CACFT members are required to be in compliance with the regulatory laws of
the jurisdiction(s) in which they practice. It is each member's responsibility to be aware of, and to ensure that they are practicing within, the laws of the jurisdiction(s) in which they practice.

AAMFT members will be grand-parented into an equivalent membership category with CACFT as long as they meet CACFT requirements
5. Truth and Reconciliation Reflection Requirement for RMFTs - Please see details about this paper on the LMFT - AAMFT grand-parent webpage. https://camft.ca/Grand-parent-application-for-LMFTS-&-AAMFT-Members

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