A. Personal Information
Name
Email (A)
NRIC/ Passport No.
Date of Birth (dd/mm/yyyy)
Age
Nationality
Address (Residence)
Postal Code
Phone (Mobile)
Phone (R)
Phone (O)
Marital Status
Single
Married
Separated
Divorced
Widow
Race
Chinese
Malay
Indian
Eurasian
Others
Language
Dialect
B. Educational Attainment (Please Enclose A Copy Of Your Transcript)
Name of Institution /University (B)
Diploma / Degree Conferred (B)
Major (B)
Year Graduated (B)
C. Skills Development In Counselling / Psychotherapy
Name of Workshop / Seminar / Courses Attended (C)
Duration (C)
Year (C)
Remarks (C)
D. Employment History
Order them in chronologically order, starting with your most recent experience.
Name of Organisation (D)
Position (D)
Date Joined(mm/dd/yyyy)
Date Left (mm/dd/yyyy)
E. Present Job Description
Maximum 500 characters limit
F. Community Involvement(s)
Name of Organisation (F)
Position Held (F)
Period (F)
Paid or Voluntary (F)
G. Practicum Hours
Click
here to download APACS Logbook
Name of Organisation (G)
Site Supervisor (G)
Hours (G)
H. Clinical Supervision Hours
Name of Supervisor (H)
Hours (H)
I. Type Of Membership Applied For
Ordinary Member S$50.00
Life Member S$800.00 (one-time payment)
Associate Member S$40.00
Student Member S$30.00
Corporate Member S$200.00
- Those who join between Jan to Jun of the year of application, will pay full fee.
- Those who join between Jul to Dec of the year of application, will pay 50% fee.
- Thereafter in the following year, full annual fee applies.
- All annual subscriptions are renewable in January of the year
* Reinstatement fee for lapse member is S$100.00 together with payment of all dues in arrears.
Those who wish to re-apply for membership shall have their application treated as a fresh application and shall be subjected to the approval of the prevailing Executive committee.
J. Accreditation Level (License Practitioner) Applied For
Educator: For applicant who wish to join as member but do not intend to practice as counsellor or psychotherapist
No additional fee
Remarks (J)
Maximum 300 characters limit
K. Proposed By Two Current APAC (S) Members of Good Standing
Name of Proposers (current APAC (S) members of good standing) (K)
Membership Number (K)
Email (K)
L. Summary Of Application
M. Applicant Not Meeting Entry Criterion
Applicants who do not meet the entry criterion may still apply and be admitted as member upon approval of the Executive Committee and after fulfilling other requirements. This will be on a case to case basis and should not be constituted as a precedent.
N. Check If You Have Completed The Following Before Submission
Upload your photo Maximum file size limit: 1MB and supported only for JPG, PNG, GIF files.
Upload your documents Maximum file size limit: 20MB. Supported only for ZIP files. Please combine all documents into one zip file and upload it. Step 1 - Put all your files into one folder Step 2 - Right click folder and select "Compressed to Zip file" Step 3 - Upload this file
O. Declaration
I declare that:
The information stated above is accurate and true to the best of my knowledge.
Upon acceptance as a member, I shall uphold the constitution, code of ethics, code of conduct and behavior and conform to the Manual of Procedures of the Association to the best of my abilities.
I have not been charged with any criminal offence(s) in any court of law.
I have read and understand the terms & conditions of my membership.
Applicant’s Signature (O)
Date (O)
P. Webpage Inclusion
Specialised Skills
Client Categories
Survey on Area Of Interests
Others
(II) To enhance my counselling / psychotherapy skills, I would be keen to attend workshops, lectures and courses related to the following topics:
Maximum 300 characters limit
It may take a few minutes for uploading the files.
Send