Membership Requirements - Montana Collaborative Professionals

Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Professional Licensure *

Please check the box(es) that best describe you.

I am an attorney in good standing with the Montana Bar Association

my license is active

my license is inactive

my license has never been suspended

my licenses is currently or has been suspended

Training and Experience *

Please check all that apply

I have received professional at least 30 hours mediation training.

I have attended a Basic Interdisciplinary Collaborative Practice Training

I have attended other relevant training

Which location(s) do you typically practice in? *

Bozeman

Missoula

Helena

Great Falls

Billings

None of the above

As a member of the Montana Collaborative Professionals, I agree to abide by the Montana Collaborative Professional Standards for the Collaborative Process. *

I agree

As a member of the Montana Collaborative Professionals, I agreed to diligently strive to practice in a manner consistent with the Minimum Ethical Standards as adopted by the Montana Collaborative Professionals. *

I agree

Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Professional Licensure *

Please check the box(es) that best describe you.

I am a Licensed Clinical Social Worker

I am a Licensed Clinical Professional Counselor

I am a Licensed Marriage and Family Therapist

I am a Licensed Psychologist

I am a Registered Social Worker

I have an equivalent license in Motnana that requires an advanced degree in a recognized clinical mental health field, requires continuing education, and is regulated by a governing body under a code of ethics

License Status *

My license is active

My license is inactive

My license has never been suspended

My licenses is currently or has been suspended

I have Background, Education and Experience in the following areas *

Please check all that apply.

Family Systems Theory

Individual and Family Life Cycle and Development

Assessment of individual and family strengths

Assessment and challenges of family dynamics in separation and divorce

Challenges of restructuring families after separation

I have expertise in child development, clinical experience with specialty focus on children and in depth understanding of children’s unique issues in dicorce (child specialists only)

I have the following training *

I have received 30 hours of professional mediation training

My mediation was focused on family law

I have attended a 3 hour Montana Family Law Training

I need information on the next Montana Collaborative Law Primer

I have attended other relevant training

Which location do you typically practice in? *

Bozeman

Missoula

Helena

Great Falls

Billings

None of the above

As a member of the Montana Collaborative Professionals, I agree to abide by the Montana Collaborative Professional Standards for the Collaborative Process. *

I agree

As a member of the Montana Collaborative Professionals, I agreed to diligently strive to practice in a manner consistent with the Minimum Ethical Standards as adopted by the Montana Collaborative Professionals. *

I agree

Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Professional Licensure *

Please check the box(es) that best describe you.

CFP [Certified Financial Planner]

CMA [ Certified Management Accountant]

CPA [ Certified Public Accountant]

CGA [Certified General Accountant

CA [Chartered Accountant]

ChFC [ Chartered Financial Consultant]

I am a certified Divorce Financial Analyst

or such other equivalent license or designation in a state, province or country that requires a broad-based financial background and continuing education, and that is regulated by a governing body under a code of ethics.

License Status *

My license is active

My license is inactive

My license has never been suspended

My licenses is currently or has been suspended

I have Background, Education and Experience in the following areas *

Please check all that apply.

Financial aspects of divorce

Cash management and spending plans

Retirement and pension plans

Income tax

Investments

Real estate

Insurance

Property division

Individual and family financial planning concepts

I have the following training *

Please check all that apply.

I have received 30 hours of client-centered facilitative conflict resolution, of the kind typically taught in mediation training (interest-based, narrative, or transformative mediation programs)

I have attended a Basic Interdisciplinary Collaborative Practice Training

I have attended a 3 hour primer in Montana Family Law

I have not attended a 3 hour primer in Montana Family Law and am interested in attending the next available training provided the Montana Collaborative Professionals

I have attended other relevant training

What location(s) do you typically practice in? *

Bozeman

Missoula

Helena

Great Falls

Billings

None of the above

As a member of the Montana Collaborative Professionals, I agree to abide by the Montana Collaborative Professional Standards for the Collaborative Process. *

I agree

As a member of the Montana Collaborative Professionals, I agreed to diligently strive to practice in a manner consistent with the Minimum Ethical Standards as adopted by the Montana Collaborative Professionals. *

I agree