Scottish Complementary Medicine Association

In association with The Lightworkers Foundation

Membership Form (Printable version)

Print your full name and initials_____________________________________________________________________________________________

Your Address___________________________________________________________________________________________________________

______________________________ Post Code________________Tel No (d) ________________________________Tel No (m)____________________

Email Address__________________________________________Web Address____________________________________________________________

Please use additional paper to list any therapies that you practice

1) Where did you train_____________________________________________________________________________________________________

3) Who did you train with________________________________________________________________________________________________

4) Who is your current insurer if any_______________________________________________________________________________________

5) What is your Renewal Date_____________6) Are you a Reiki Practitioner______If yes you will receive a licensed to practice Reiki from the SCMA

7) Would you like to be listed on the SCMA website as a practitioner yes/no - If yes please print the appropriate text for your web entry as you would like it to appear on a separate sheet and send it with your certificates or email it to info@scma.org.uk

I agree to abide by the SCMA Code of Conduct

Please Sign here _____________________________________Date ______________

I am enclosing my SCMA membership fee of £30 made payable to The Lightworkers Foundation (SCMA)

Please send your cheque and copies or your therapy & insurance certificate/s (if applicable) to

I wish to pay by Pay Pal £30

The Lightworkers Foundation SCMA Ass. Cedar Lodge, Rashfield Dunoon. Argyll. PA23 8QT

We will not share your information with any other person

or organisations. If you practice Reiki you will receive your license at the same time

SCMA

In association with The Lightworkers Foundation

Tel 01369 840486

Web: www.scma.org.uk           Email: info@scma.org.uk