Member Application - Philadelphia Center for Emotionally Focused Therapy

Date*

Name*

First Last

Address*

Street Address City State ZIP Code

Phone*

Email Address*

Website

Applying as a:*

New Member
Renewing Member

Profession*

Profession (Other)

Degree*

Degree (Other)

Licensed as a...

Are you a Certified EFT therapist?*

Yes
No
In the process

Are you a Certified EFT supervisor or supervisor-in-training?*

Yes
No

Payment (Renew by 12/31/22 and receive $10 off the cost of Full or Associate membership. Discount taken at checkout.)*

PCEFT Full Membership $90
PCEFT Associate Membership $55
PCEFT Student Membership $25

NOTE: A full PCEFT member MUST be a member of ICEEFT and have completed an Externship. If you haven't completed an Externship and/or are not a member of ICEEFT please select Associate Member status.

Are you an ICEEFT Member?*

Yes
No

You must be a Member in good standing of ICEEFT to join PCEFT as a FULL MEMBER.

Have you completed an EFT Externship?*

Yes
No

Have you completed Core Skills?*

Yes
No
Currently in Core Skills training

How do you want your Directory Listing to read?

Be specific as to your degree, licensed and any certifications and include your phone number, email and website.

I have reviewed my directory listing on the website and have no changes.

Yes

I have reviewed my directory listing on the website and have the following changes:

Directory Picture

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Please upload a headshot for the directory listing.

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