GTILA Apply For Membership To join, please submit the application below. The GTILA Membership Committee will review the application and then contact you. Membership Application First Name Last Name Username* Password* Confirm Password*Please make note of your Username and Password. You will need them to log in and complete your profile once your membership is approved.E-mail Address* Phone Website Degree and License Designation Professional License*Associate Clinical Social Worker (ASW)Associate Marriage & Family Therapist (AMFT)Associate Professional Clinical Counselor (APCC)Licensed Clinical Social Worker (LCSW)Licensed Marriage & Family Therapist (LMFT)Licensed Professional Clinical Counselor (LPCC)PsychologistNoneLicense Number* Supervisor Name* Supervisor License Number* Certifications and Special TrainingDescribe your training in Gestalt therapy.* Only fill in if you are not human Login
