<p>APPLICATION FOR ENTRY IN IDTA PRACTITIONER REGISTER</p><p>Please type and boxes will expand to fit. Information on this page is for publication.</p><p>CONTACT DETAILS FIRST NAME: click here to insert text LAST NAME: click here to insert text ORGANISATION (optional): click here to insert text PHOTO ATTACHED (optional): CONTACT PHONE NUMBER: click here to insert text EMAIL ADDRESS: click here to insert text WEBSITE ADDRESS: click here to insert text SKYPE ADDRESS: click here to insert text CATEGORY – tick as many as apply: Consultant Trainer Educator Coach Teacher Counsellor (non-therapeutic) Other (specify) click here to insert text LOCATION OF SERVICES (choose one) Worldwide Pan-Europe Countries (specify) click here to insert text Town or locale (specify) click here to insert text WORKING LANGUAGES(s) click here to insert text SERVICES PROVIDED (max 300 words) click here to insert text Attachment (optional – can attach one pdf or word doc about services, etc) BIOGRAPHY (max 200 words – excluding qualifications) click here to insert text Attachment (optional – can attach one pdf or word doc of CV, resume, etc) OTHER QUALIFICATIONS HELD click here to insert text</p><p>Please continue – the following information will not be published and is required to enable us to assess your application. INSERT HERE OR ATTACH A LOG OF THE DATES/HOURS OF TA SUPERVISION YOU HAVE RECEIVED FROM A P/TSTA – PLEASE STATE THEIR FIELD click here to insert text Attachment (optional – can attach the log one pdf or word doc) INSERT HERE OR ATTACH A LOG OF THE DATES/HOURS OF TA TRAINING YOU HAVE RECEIVED FROM A P/TSTA – PLEASE STATE THEIR FIELD click here to insert text Attachment (optional – can attach the log one pdf or word doc) INSERT HERE OR ATTACH A LOG OF THE DATES/HOURS OF TA PROFESSIONAL SERVICES YOU HAVE PROVIDED TO OTHERS. PLEASE STATE THE TYPE OF CLIENT (E.G. INDIVIDUAL, GROUP, ORGANISATION, FAMILY, CLASS, ETC) AND THE NATURE OF THE SERVICE (E.G. COACHING, TEACHING) click here to insert text Attachment (optional – can attach the log one pdf or word doc) PLEASE EXPLAIN HOW YOUR SERVICES FIT THE FRAMEWORK OF DTA (max 300 words) click here to insert text Attachment (optional – can attach one pdf or word doc about services, etc) PLEASE TELL US HOW YOU MANAGE THE V=BOUNDARIES OF YOUR WORK, INCLUDING PARTICULARLY HOW YOU MAKE SURE THAT CLIENTS KNOW YOU ARE NOT YET QUALIFIED AND THAT YOUR SERVICES CANNOT BE COUNTED AS HOURS TOWARDS ANY TA QUALIFICATIONS THEY MAY SEEK THEMSELVES (max 200 words – excluding qualifications) click here to insert text</p><p>I confirm that I have read the Requirements for Entry with the IDTA Practitioner Register document and that I will advise IDTA if at any time I fail to meet those requirements. Signature (a typed name in a form saved and sent by email will be treated as a signature) click here to insert text Date click here to insert date</p><p>Please save and email completed form and any attachments to [email protected]</p>