Country of residence: AustraliaNew Zealand If you are 60 or over, please note your birthdate:
Please select your STANZA/ISST Membership Status by ticking the relevant boxes:
Full MemberRetired Member: A full member who is 70 years of age or over and working 400 hours or less per yearCSTCST-T
I confirm that:
As per my original application for STANZA Associate Membership, I hold a current membership and/or registration in a professional association for Art Therapists, Counsellors, Medical Practitioners, Mental Health Practitioners, Psychologists, Psychotherapists, Social Workers, or other recognised mental health profession or pedagogy profession OR a license to practice in a mental health profession.
I hold current professional indemnity insurance.
I do not have a criminal record that may prejudice the interests and safety of children.
I hold a current Working with Children Check (only applicable if your practice includes working with children).
I have not been convicted or a crime in any state or country.
I have not been dismissed from employment on the grounds of professional misconduct.
I have not been refused membership of a professional association or registration board on the grounds of professional misconduct, unprofessional conduct, incompetence or negligence in any state or country.
I do not have any complaints, charges or investigations pending against me for any violation of ethics codes, professional misconduct, unprofessional conduct, incompetence or negligence in any state or country.
I have not had a professional liability claim made against me.
The information contained in this application is true and correct to the best of my knowledge and does not contain any false or misleading information regarding my membership or identity. I understand that any deliberate misrepresentations in the information that I have supplied will jeopardise my renewal of membership with STANZA.
I confirm the above to be true