Registered Play Therapist Application

Fill in your details below to apply for Registered Play Therapist Membership with PTPA!

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Your First Name*

Your Last Name*

Email*

Phone Number*

Postal Address*

QUALIFCATION DETAILS

Please list your University qualifications (non-play therapy):*

Upload your degree(s) here:*

Drop files here or click to select

Please list your Play Therapy qualification(s):*

Upload your certificate(s) here (hours must be listed):*

Drop files here or click to select

WORK DETAILS

Where are you currently working?

Which theory or approach informs your practice as a play therapist?

CLIENT HOURS

Have you completed 300 client hours since graduating from your play therapy qualifcation?

Yes

Upload your client hours (letter from employer, supervisor or stat dec with hours listed)*

Drop files here or click to select

SUPERVISION HOURS

Have you completed the required supervision hours with a Registered Play Therapist since graduating from your play therapy qualification?*

Yes, I have completed 40 hours of supervision

Yes, I have completed 30 hours of supervision and 10 hours of personal therapy

No, I haven't completed my hours yet

Upload your supervision hours (letter from your supervisor)*

Drop files here or click to select

Upload your personal therapy hours (letter of confirmation from your therapist)

Drop files here or click to select

Please list your supervisor's details - name, email and association registration:*

INSURANCE DETAILS

I have my own insurance to work as a play therapist

My employer's insurance covers me to work as a play therapist

I need this membership to get insurance and will email the document once obtained

Upload Your Insurance Documents here:

Drop files here or click to select

Employers contact details:

WORKING WITH CHILDREN CHECK

Do you hold a current:*

Working with Children Check

Police Clearance

Other relevant check

Must be lodged and accepted according to legislation within the state/country in which you work in. Police Clearance must be current within the last year of the date of your application.

WWCC Upload

Drop files here or click to select

COMPLAINTS AND LEGAL MATTERS

Have any formal complaints been made against your professional conduct or have been involved in legal matters regarding your professional conduct?*

Yes

What was the outcome of this?

DECLARATION FOR MEMBERSHIP

In making this application I acknowledge that if accepted as a Play Therapy Practitioners Association Member that in my play therapy work with children and families, I will comply with all relevant PTPA Best Practices Guidelines as stated by the Association.

I CONFIRM THAT:

I do not have a criminal record that may prejudice the interests of children.
I have not been dismissed from employment on the grounds of professional misconduct.
I have not been refused membership of a professional body or register in a related field on the grounds of professional misconduct.
I agree to adhere to the PTPA renewal requirements for continuing clinical supervision and clinical practice.
The information detailed in this membership application form is true to the best of my knowledge and does not contain any false or misleading information regarding my experience, qualifications, practice, membership or identity.
I am aware my information contained and provided in this application will be held by PTPA.
Should a complaint be received by PTPA regarding my conduct, I will comply with all investigation processes undertaken by the Association and will be advised of the outcome in a timely manner.
Should a complaint be lodged against me with another association, body or board of which I am a member or registered with, I agree to inform PTPA of the outcome of the complaint within 14 days of the decision.
I understand and accept that PTPA reserves the right to terminate my membership if there is a breach of any of the above conditions or if there are ethical concerns about my work.

I agree

I disagree