Australian Hypnotherapists’ Association

Founded 1949 - ABN 20 004 388 872
" and its member associations ASTA and ASHOCHA "
P: 1300 55 22 54
E: admin@ahahypnotherapy.org.au W: www.ahahypnotherapy.org.au

Application for Student Membership

IMPORTANT! All application’s are to be submitted via this digital form, forms received in printed form will be rejected.

Max length is 30. Required.
Max length is 30. Required.
Required. Valid e-mail address. Max length is 70.
Max length is 70.
Max length is 128.
Max length is 100.
Max length is 30.
Max length is 60.
Max length is 60.
Max length is 60.

Your postal address

Max length is 80.
Max length is 50.
Max length is 10.
Max length is 15. Required.
Max length is 50.

Markdown wiki syntax Max length is 15000.
Markdown wiki syntax Max length is 15000.
Markdown wiki syntax Max length is 15000.
Markdown wiki syntax Max length is 15000.
Have you ever been refused acceptance or had any disciplinary action taken against you by any other association?
Yes No    If ‘Yes’ please give details below.
Have you ever been convicted of a criminal offence (not including minor traffic offences)?
Yes No    If ‘Yes’ please give details below.

I advise that I am currently engaged in a program of study and I enclose evidence of study herewith.
Markdown wiki syntax Max length is 5000.
Markdown wiki syntax Max length is 5000.
Yes No

Attachment below could be of [.doc(x), .pdf, .jpg, .png, .txt, .rtf]. Max size per attachment 5MB.

I have read and agree to the membership criteria for Student Membership as detailed in the AHA Prospectus and I agree to abide by the AHA’s Code of Ethics. I agree to hold the AHA indemnified for all judgments and costs awarded against it or incurred by it, as the case may be, in any action against it, arising directly, or indirectly from my conduct or from my practicing hypnotherapy.

AHA Advisory Line 1300 55 22 54