Membership Application or Renewal

Membership Application or Renewal
You may join OCCEFT without being a member of ICEEFT. However, current membership in ICEEFT is a prerequisite for being listed in the OCCEFT "Find a Therapist" directory.*

I am a current member of ICEEFTI am not a current member of ICEEFT
Annual Membership Dues*

$40 - Student or Intern$80 - Licensed
Payment*

Please email me a link to pay by credit card
Name*
License Type*
License or Intern Number*
Supervisor Name and License Number, if you are prelicensed
Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you have a second office?

YesNo
Business Address #2

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number*

Area CodePhone Number
Business E-mail*
Business Website
EFT Training Level (check highest level completed):*

Four-day ExternshipAdditional training with EFT supervisionCertified EFT TherapistCertified EFT Therapist and Supervisor
Photo
If you would like to include a photo with your listing, please email your photo to betsy@occounseling.net.
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