International
Somatic Movement Education & Therapy Association
Voicemail
(413) 446-6009
Email
info@ismeta.org
Application for ISMETA membership
Please
type or print clearly
Name: ________________________________________________ Date of
Application:_____________________________
Address: ______________________________________________ Phone (s):
home: _____________________________
______________________________________________ work:
______________________________
______________________________________________ fax: _______________________________
e-mail: ______________________________________ website:
_______________________________________________
Company/Organization/Affiliation: _________________________________________________________________________
PLEASE ENCLOSE THE APPROPRIATE APPLICATION FEE
_____$15 one-time non-refundable processing fee for graduates of an ISMETA- approved training program (see our brochure or website for a list of ISMETA – approved training programs)
Payment Enclosed
I have already paid online
_____$75 one-time non-refundable processing
fee for applicants who are not graduates of an ISMETA-approved training program
Payment Enclosed
I have already paid online
ASSOCIATE MEMBERSHIP (no documentation required)
_____$65/year membership
Payment Enclosed
I have already paid online
PROFESSIONAL REGISTRY
_____ Membership
dues will be paid upon acceptance to ISMETA. *
* $100 annually or $170 for both titles. There is a $10 fee for each Certificate of Registry.
Multiple
year discounts: $170 - two years single registration
$290
- two years dual registration
$220 - three years single registration
$400 - three years dual registration
REGISTRY REQUESTED: _____Registered
Somatic Movement Educator (RSMESM)
_____Registered Somatic Movement
Therapist (RSMTSM)
_____BOTH
Payment Enclosed
I have already paid online
Guidelines
for Registry Selection – Factors to consider
At this time selection of professional title can be
self-determined (unless explicitly stated otherwise by your training program)
·
Does the training program you graduated from have a
distinct preference regarding type of registry?
·
Is the orientation of your somatic movement practice
focused more on education or therapy?
·
According to the regulations in your state or local
government, are you legally considered an educator or a therapist?
·
Do you qualify for both or prefer both?
DOCUMENTATION: (Please send application documentation electronically to info@ismeta.org when possible)
1) Evidence of Education (PLEASE COMPLETE A OR B)
A._____Copy of Certificate from ISMETA - approved training program
-please see our brochure or website to determine if your training program is an ISMETA - approved training program
-For
students/graduates of LIMS: In order to apply for RSMESM or RSMTSM,
an additional 100 hours of
professional training are needed. Please request complete guidelines.
OR
B._____ Required documents if you have not completed an ISMETA - approved training program
_____detailed transcript of your movement training and copies of all pertinent certificates
_____a catalog or brochure of the school(s) OR biographies of the instructors
_____a video tape (VHS
detailed descriptive case analyses of four typical sessions (Please use an alias to ensure your clients’
confidentiality.)
*After review of
this information, we may also direct you to an ISMETA-approved training program
or Registered Somatic Movement Educator
or Registered Somatic Movement Therapist in your area so that they can
observe your practice.
2) Reason for Joining ISMETA
______Send a short statement that describes the reason you desire registration with ISMETA
3) Two letters of recommendation (with reference to your history of professional practice)
_____One letter from an
instructor of an ISMETA-approved training program or an experienced colleague,
ideally someone who provided you with supervision.
_____Letter from
client and/or colleague
4) Evidence of 150 hours of professional practice 75 hours must be post graduation from your Somatic Movement Education or Somatic Movement Therapy training program. Of the entire 150 hours at least 75 hours must be sessions with individuals.
_____Cover Letter detailing the history of your practice (Include number of hours, dates, settings and a
general description of the movement issues/syndromes you address. Make reference to the principles you apply and the types of skills you use, especially if you combine several approaches.)
I, (signature)____________________________________________ attest, under the penalty of perjury that the enclosed documents are truthful.