Affiliate Application Form

Please review the information on the Membership explained page and be sure you have all the necessary information ready to complete your application. Please Complete the Two Step Process for completing your application for membership with The Canadian Association for Couple and Family Therapy. Please read Step 2 before submitting your application form.

Affiliate Membership is intended for professionals who are looking to be part of a community of systemic professionals and access related resources, though they do not meet the requirements for registration as RMFT or other categories on that path. These professionals have completed other relevant education and are in a professional career (e.g. nursing, medicine, occupational therapy, counselling, therapy, teaching, etc.). They are regulated through registration, certification, or licensure, as applicable and are working within their scope of practice, experience, and knowledge. Affiliate Members will have opportunities to network with other systemic practitioners, and stay up to date on research, best practice, and relational therapy in a Canadian context. *** This membership is a general membership category and does not constitute certification, registration, credentials, or licensure.

Preferred Prefix

Preferred Pro-Noun

Legal First Name

Middle Name or Initial

Legal Last Name

Email*

This is the email address all CACFT correspondence will be sent to.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Home or Cell Number*

Area CodePhone Number

Work Phone Number

Area CodePhone Number

Are you a mental health practitioner?*

YesNo

If you are a mental health provider why do you believe you belong in this membership category rather than Associate membership or RMFT membership?

What is your occupation?*

What is your Masters Degree?*

Please attach your Masters Degree*

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Practice Setting

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.

Would you like to join a CACFT Branch? If yes, please indicate which Branch you would like to join.

BC BranchABMBSK

Please note: when you join a CACFT Branch you will be required to pay Branch annual dues as well as CACFT annual dues.

CACFT Affiliate Member annual dues are $90.75 plus tax.

Please click here to read about CACFT Branches.

The annual CACFT membership fee for an Affiliate Member is $90.75 plus taxes. After your membership application is approved you will have fourteen (14) days to pay your annual membership fee.

After you complete the form above you will be redirected to our payment page.

The application fee is non refundable.

If you prefer, you may mail a cheque payable to: CACFT to:

CACFT
Post Office Box 1064
Tottenham, Ontario, L0G 1W0

Affiliate Application Form

Step Two