Professional Status Application

I hereby certify that I am in compliance with the definition of a Professional as currently stated in the Rules, Standards & Policies of the MFTHBA.

Name *
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Number Phone Number * - ### - ### ####
Email *
Member Number *
Fee Schedule

Please refer to the MFTHBA Rules, Standards & Policies book for fee Schedule.
Application and appropriate fees must be received before request can be processed. One must have a current MFTHBA membership.
$0

Total

+Processing Fee 4%