Retired Membership

by | Oct 27, 2018 | 0 comments

Designed for those who are or were at sometime licensed and are currently retired from the field of counseling.

Terms:

$30 / Year

First Name:* First Name Required

Last Name:* Last Name Required

Address Line 1:* Address Line 1 is Required

Address Line 2: Address Line 2 is not valid

City:* City is Required

Country:* Country is Required

State/Province:* State/Province is Required

Zip/Postal Code:* Zip/Postal Code is Required

Cell Phone:* Cell Phone is Required

Other Phone: Other Phone is not valid

County (select Out-of-State if outside of Tennessee):* County (select Out-of-State if outside of Tennessee) is Required

Grand Region (select Out-of-State if outside of Tennesse):* Grand Region (select Out-of-State if outside of Tennesse) is Required

Region (for this field, please choose the region based on the county you provided; select Out-of-State if outside of Tennesse):* Region (for this field, please choose the region based on the county you provided; select Out-of-State if outside of Tennesse) is Required

License Type:* License Type is Required

Other License Type: Other License Type is not valid

Other Degree(s): Other Degree(s) is not valid

Highest Degree Concentration (or Current Degree Program Concentration for students):* Highest Degree Concentration (or Current Degree Program Concentration for students) is Required

Other Highest Degree Concentration: Other Highest Degree Concentration is not valid

Are you a National Certified Counselor (NCC)?: Are you a National Certified Counselor (NCC)? is not valid

Yes No

Are you a member of the American Mental Health Counselors Association (AMHCA)?: Are you a member of the American Mental Health Counselors Association (AMHCA)? is not valid

Yes No

Are you a member of the American Counseling Association (ACA)?: Are you a member of the American Counseling Association (ACA)? is not valid

Yes No

Are you interested in serving on any of TLPCA's committees?: Are you interested in serving on any of TLPCA's committees? is not valid

Yes No

Please list any other relevant memberships for state or national associations/organizations: Please list any other relevant memberships for state or national associations/organizations is not valid

Username:* Invalid Username

Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

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Terms: $30 / Year

Description	Amount
Retired Membership – Initial Payment	$30.00
Total	$30.00

TLPCA Membership

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Retired Membership

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