Professional Hypnotherapy Practitioner Association Application Form



Membership is open to practicing Hypnotherapists who have undertaken training in this discipline.


Please submit this form online or print.


To become a 'verified member' please send photocopies of evidence of training/certificates

and current insurance.

Please enter your full name including title


Please enter full address, including postal code and country

Name as it is to appear on certificate

Telephone Number (including area code)

Email address

Website address

Number of years in practice

Relevant training courses attended and dates

Membership to other professional organizations

Have you ever been convicted of a criminal offence?   Yes  No


Have you ever had any disciplinary action taken against you by any professional

organizations?   Yes  No


Do you wish to attend any of the organized PHPA events in Yorkshire?    Yes  No



Membership is £50.00  per year.  Please send cheque or postal order to:


Hypnotic World, 24 St David's Drive, Doncaster, Yorkshire, England.  DN5 8NF  Telephone +44 (0)1302 786977


Your membership will commence from the date that payment is cleared and your certificate will be dispatched within 14 days..