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Personal Information

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Contact Number

Training

Highest NLP Qualification

Organisation Trained With

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Organisation Email Address

Name of Certifying Trainer

Hours in Training

Overall number of hours of training in classroom with direct training contact (combined certifications)

Course Evaluation Process(es)

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Associated Training/Qualifications

e.g. hypnotherapy, counselling, coaching etc

Certificates

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Practitioner Certificate

Master Practitioner Certificate

Experience

Main Field in Which You Use NLP

Other

Supervisor's Name

Supervisor's Email Address

Supervisor's Contact Number

Terms & Conditions

I confirm that I have completed a minimum of 25 client hours under the supervison of a professional supervisor

Should NZANLP deem it necessary, I give permission for the Association to contact my Supervisor

I am aware of and committed to meeting ongoing requirements for supervision and professional development as a Professional Member of NZANLP

I have read and agree to abide by the NZANLP Constitution, Codes of Ethics and Practice, and Complaints and Disciplinary Procedure 2008 while a member of NZANLP

I agree that submitting this form and paying the associated membership fee constitutes my electronic signature and confirm that the information I have provided is accurate and true.