DT registration Sorry - Membership detailsInstructions Please fill in the form accordingly and ensure that all that have asterisks (*) must be ticked or filled-in.Membership ID *Registration or Badge Number Full Legal Name Registration type *New Registration DeclarationI have read and agree with the NZSDRT Inc. Code of Ethics and Standards of Practice. *AgreeI agree to NZSDRT Inc. seeking further information at its sole discretion before approving my registration* AgreeIf my application is successful, I agree for my name to be added on the list of Registered Diversional and Recreational Therapists that is published from time to time on the website or in print. *AgreeMy current fee after becoming a Registered Diversional and Recreational Therapist is indicated above *AgreeMy name will be removed from the published registered members list IF I fail to renew my registration. *Agree Reference #1Name *Position *Email *Phone number * Reference #2Name *Position *Email *Phone number * Your detailsHave one (1) year of current Membership with the NZSDRT Inc. *YesNoCompleted a minimum of 3000 hours working in the field. Confirm you meet the criteria and attach details of hours history.* YesNo Evidence of current education relating to Diversional and Recreational Therapy i.e. conferences, in-services (signed by Manager) you have attended in the last twelve months:* Current written & signed reference from supervisor or professional colleague attached: *Have you ever been declined or had registration suspended or cancelled by any organisation? YES/NO *YesNoIf yes, which organisation/s? Are there any other matters of which the National Registration Board should be aware of which may affect this application? *YesNoIf yes, please explain Text VerificationThis box is for spam protection - please leave it blank:
