NFH Union Application Form

By submitting this form I understand that choosing to pay my dues monthly, the 1st payment will be $20 new member activation fee + $15 member dues. (Total $35.) My credit card will automatically be charged $15 per month for the next 11 months. During this period I will receive my certificate, membership card, and complete information about utilizing the Union benefits. Plus, in addition I will receive from the National Guild of Hypnotists $100 worth of free products and/or discounts during my 1st year of NFH membership.

*Note: Bold fields represent required information.

Choose Membership:
Email Address:
First Name:
Last Name:
Title:
Organization:
Phone Number:
Fax:
Street:
City:
State/Province:
Zip/Postal Code:
Country/Region:
I am already Certified by (Organization):
Date of Birth (mm/dd/yy):
Practiced hypnotism since(mm/dd/yy):
Practice Type:
NFH Membership #: (US Members can use last 6 digits of Soc. Sec. No.)
Highest Level of Education:
Degrees Attained:
College/University(s) Attended:
Hypnotism Training School and Instructor:
NGH Member #:
Credit Card Type:
Card Holder Name:
Credit Card Number:
Expiration Date (mm/yy)
CVV Code:
The CVV Number ("Card Verification Value") on your credit card or debit card is a 3 digit number on VISA®, MasterCard® and Discover® branded credit and debit cards. On your American Express® branded credit or debit card it is a 4 digit numeric code.
If billing dddress is different from residence, please provide the correct address below:
Please fill out this section with the characters provided:
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