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Follow the three steps to renew your membership of BAPT by 31st ...

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Follow the three steps to renew your membership of BAPT by 31st ...the,your,The

     stFollow the four steps to renew your membership of BAPT by 31 October.

    BAPT Full Membership Renewal

    th1st October 2011 to 30 September 2012

1) PAYMENT

; I wish to pay the subscription in by cheque and enclose my cheque for ?100.00, made

    payable to The British Association of Play Therapists. Please write your name and

    member number on the reverse of the cheque.

    ; I have transferred the sum of ?100.00 by Internet bank transfer to HSBC, Sort Code: 40-

    30-24, A/C No: 41808591, A/C Name: British Association of Play Therapists, quoting

    membership No Please ensure you quote your membership number or we will be

    unable to identify who the payment is from.

    ; I will pay ?100.00 by Standing Order. Please arrange this through you own bank, giving

    them the following details: HSBC, Sort Code: 40-30-24, A/C No: 41808591, A/C Name: stBritish Association of Play Therapists Payments should be made on the 1 October

    each year. Please ensure you quote your membership number or we will be unable

    to identify who the payment is from.

; I will pay by Pay Pal via the website. Please ensure you quote your membership

    number or we will be unable to identify who the payment is from

GIFT AID

    ; Please treat this payment and any payments made in the future as Gift Aid donations. Or, ; Please treat this payment and any payments made in the last 6 years or any future

    payments made as Gift Aid donations.

Please note that an administration charge of ?10.00 will be made on all payments thAFTER 30 October

2) YOUR DETAILS

Please complete the details below in block capitals. All information is held in

    confidence and will only be used for BAPT related activities. Your name and address will not be passed to any third party. Cherries Ltd, our database holder, is registered with the Data Protection Registrar under reference number Z5415296 Name Membership no.

    Address:

Email Address:

    Home Telephone:

Work Telephone:

    Mobile:

Continued…….

    3) DETAILS OF YOUR SUPERVISOR

a) Supervisor’s name and address:

b) Is your Supervisor BAPT registered? Yes No

    If your supervisor is not BAPT registered or a BAPT member, it is your responsibility to ensure that they meet the BAPT criteria as listed on website http://www.bapt.info/supervision.htm#bm1

    c) Please confirm the number of hours of supervision you have received in the year, in line with the minimum hours specified on the website.. (If you work part time as a Play Therapist these hours are pro rated to your working hours)

Individually ______________________

Group ______________________

     d) Verification and signature of supervisor.

Signed……………………………………………………..Date……………………2011

4) MEMBER DECLARATION

I confirm that:-

    a) I do not have a criminal record that may prejudice the interests of children. b) I have not been dismissed from employment on the grounds of professional

    misconduct.

    c) I have not been refused membership of a professional body or register in a

    related field on the grounds of professional misconduct.

    d) I have read and will abide by the criteria defined in the Code of Ethics and

    Practice of the British Association of Play Therapists.

    e) I have a current (less than 3 years old) CRB check:

     CRB number

     Date of issue

Signed……………………………………………………..Date……………………2011

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