Membership Registration

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Join the TNAPT Here

Username *

User Email *

User Password *

Confirm Password *

Licensure Information

Ordained and/or endorsed to the ministry of pastoral therapy/counseling by a religious endorsing body? *

Licensed counselor or therapist in the state of TN? *

Under supervision for counseling or therapy licensure in the state of TN? *

Who is your supervisor and what is their professional license? *

Currently Held License(s) *

LCPT
Temp. LCPT
LPC-MHSP
Temp. LPC-MHSP
LPC
LMFT
Temp. LMFT
Unlicensed
Other

Please provide what license you currently hold. (ex: LCSW, Psychologist, etc.) *

What license are you pursuing? *

LCPT
LPC-MHSP
LPC
LMFT
Other/None

Please provide what license you are pursuing. *

Personal Information

Preferred Title *

First Name *

Last Name *

Contact Information

Phone *

Please Provide an Email Address You Would Like Published *

Practice Name/Employer *

Practice/Employment Address

Would you like to have your practice address published? *

Practice Website

ACPE Membership

Type of ACPE Membership *

Education Background

Bachelor's Degree Information

Bachelor’s Degree Field of Study *

University *

Year Completed *

Have you completed a masters degree? *

Religious Affiliation

What is your denomination/religious affiliation? *

Master's Degree Information

Master’s Degree Field of Study *

University *

Year Completed *

Have you completed an additional graduate degree? *

Additional Graduate Degree Information

Degree Level *

Field of Study *

University *

Year Completed *

Would you like to include one last applicable earned degree? *

Final Degree Information

Degree Level *

Field of Study *

University *

Year Completed *

Membership Selection and Payment

Choose your membership subscription level. This membership will auto-renew each year on this date. You may cancel at any time. (Some membership levels require verification. Thank you for your patience with the verification process.) *

Regular Member – USD $75
Under Supervision Member – USD $50
Retired Member – USD $25
Student Member – USD $0

Total

USD $0.00

Stripe Gateway *