Certified Practitioner Membership Application

$100.00

Certified Member Application
First
Last
Only current APFM practitioner and advanced practitioner members may apply to become Certified members. Learn more about our membership categories.
Please provide the following information:

  • Certificate of completion for 40-hour basic family mediation training with training in domestic violence.
  • Certificates of completion for additional 40 hours of training or continuing education in family mediation.
  • For Advanced Practitioner level only: Certificates of completion for additional 20 hours of training/practicum or continuing education in mediation practice skills.
  • Proof of Malpractice Insurance

**If certificates of completion are not available please provide a list of trainings and include the title, date, trainer, and number of hours.

Upload the documents in the "Document(s) Upload" box below. Only PDFs and JPEGs are permitted. Maximum file size is 5MB. No more than 5 files may be uploaded.

Maximum upload size: 5MB
When you click on the "Submit Application" button below you will be taken to PayPal to securely pay the $100 application fee.

Pin It on Pinterest

Share This