Application – STR

 

We welcome your application to be Registered as a Sandplay Therapist. Please complete this form and follow the instructions for submission of attachments. Please remember to submit your STR membership fee – See the Payments page

Beginning with STR Applications submitted January 2019 or after, a MAST membership of a minimum of one year is required. It is important that we support our organization in the process of seeing certification from AST.

Please note that applicants for STR and STR-S must first be MAST members of the Association.

Your Name (required)

Your Address (required)

Your City or Town (required)

Your State, Region or Province (required)

Your ZIP or Postal Code (required)

Your Country (required)

Your Phone (required)

Your Fax

Your Email (required)

Education

License or Certification if required to practice in your region

Liability Insurance Carrier & Policy Number

List Sandplay trainings you have taken, with whom, training titles, dates & hours of training:

Online Coursework - List Courses & Dates of Completion:

Or, Online Quiz in Fundamentals - Date of Completion

Or, Online Quiz in Sandplay Understanding - Date of Completion

Personal Sandplay Experience - With Whom & Dates

Written Summary of Personal Sandplay Experience - not to exceed 500 words

Consultation - Dates, Hours, list group or individual sessions & Consultant's Name

Case Review Session with RST-C or RST-CT. Dates of: Recommendations, Completion of Recommendations, if any & Consultant Approval. Provide in writing signed by Consultant

Disposition to Sandplay Work
By assigning my name hereunder, I agree that I understand the power and depth of Jungian Sandplay, and understand that practicing Sandplay is a sacred responsibility that demands reverence and humility. To maintain these values I agree to practice loving compassion with my clients, colleagues and with myself.

If I ever begin to feel seduced by the power of Sandplay I agree to seek immediate supervision and/or therapy. I acknowledge that the Council of Mentors may also call me in for review and direct me to seek supervision and/or therapy. I agree to comply with the Council's recommendations or be subject to suspension or termination of Registration in accordance with the AST Charter.

If a colleague is acting in a way that is disordered to Association’s core values I agree to bring this to the attention of the Council of Mentors with a guarantee of confidentiality.

Yes, I agree.

Would you like to be listed on the AST Membership web page? If yes please write your name, degree, license, location, email and/or website address. Write your name as you would like to have it on your Registration Certificate. Email us a photo for the website Directory, 2x2" 72dpi. Please note that it is preferable to use a website address instead of an email address, if available. Web crawlers often search for email addresses to send out spam.

Please email: Photo for Member Directory Page on website

Please note that your dues must be paid at the time of your application.
I hereby attest that all of the information I have submitted above is true and accurate

Yes, I agree.

[recaptcha]



Please go to the "Payments" page to pay your STR membership fee

Loving Kindness, Clarity & Humility in the Practice of Sandplay Therapy