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Bach Flower Practitioner Alliance
Member Application

 

2022 Application

 

 

This form may be used by practitioners who have completed a Bach Flower Education or Bach Foundation approved Level 3 Practitioner Training and Homestudy program.

 

Before submitting please read 

The Practitioner Promise  

By submitting this form, you agree to follow the tenets of

The Practitioner Promise

 

Once you have submitted this form, please remit your membership fee here

* Required fields
Name *
E-mail Address *
Month and year of Practitioner completion/certificate issue (OK to estimate this) *
Location and Course Teacher for your L3
Your Street Address *
City *
State *
Zip *
Country *
Daytime Phone Number *
Evening Phone Number
Mobile Phone Number
Telephone Number to be given to clients (please specify ONE number only) *
Email address where we may contact you. Please note, all Alliance communication is sent via email.
Email Address which may be published for clients :
Website Address which may be published for clients:
Some of my contact details have changed *
What is your current occupation? *
What other therapies do you offer? *
Languages spoken:
You have my permission to publish my name, city, state, zip and how clients may contact me as listed above on the Bach Flower Education and/or Practitioner Alliance website *
I understand that the Practitioner Alliance purchases advertising with various professional organizations in order to publicize the work of practitioners. I agree that Bach Flower Education and the Practitioner Alliance may share the public contact details I have listed to other select organizations which publish practitioner listings to help promote my practice. *


 


  

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