Albany, NY 12211

Make your check payable to Diane Miles, I have to pay for the back ground check, that account is in my name.

Thanks. Please fill out all fields as accurately as possible as the more information you supply will allow you certification to precede quickly. Please use an additional sheet for extra information if needed.

Name: _______________________________________________

Date: ________________________________________________

Address:______________________________________________

State and Zip:__________________________________________

Social Security #:________________________________________

Drivers License # and State:_________________________________________________________________________

The last two are needed for legal background checks. If you do not wish to send this information through the mail, you may ask your local police department to run the back ground check and send us a notarized copy of same. Prices vary in different areas.

I would like The Association Of Certified Psychics to include me as a qualified and certified Psychic. I give The Association Of Certified Psychics full permission to use all information supplied on this application and to contact the references I supply to verify all information for the purpose of becoming a certified Psychic.

I understand and agree to abide by the rules and regulations governing The Association of Certified Psychics. I certify that I have read and do agree to all rules and regulations as set out within this the governing body that will be the body of Psychics that are to be voted on by all members in good standing and who will set out the rules and regulations. I further agree as a member in good standing that I will receive all information and updated data regarding any changes or additions of new members on a monthly basses.

1. All members of The Association of Certified Psychics do agree to abide by all rules and regulations that may be instigated by the ruling body at their annual meetings and to follow these rules and regulations.
2. As a member I agree and affirm that I am a true and metaphysically gifted Psychic and that I agree to use my given gifts for the help and guidance to all that are in need of metaphysical help and that if a person is in need of my gifts and is truly unable financially to pay for my services I will never turn a person away who truly needs my help.
3. I will conduct myself at all times in a professional and ethical manner and will at no time misrepresent myself or my abilities for the purpose of financial gain.
4. I as a member of The Association of Certified Psychics do agree that I will never allow myself to work on any line or service that forces me to use unfair and unethical practices to keep any caller on the phone for the purpose of building up there charges or permits persons not metaphysically gifted to answer or give readings to callers.
5. I understand that as a member of The Association that it is my place to do everything within my power to uncover and discredit all and anyone involved in unethical and disreputable practices that may cause damage or controversy within the industry.

I have read and do agree to all the above rules and regulations and now apply to The Association of Certified Psychics for membership I also agree to abide by all and any rules and regulations now in force and that may be instigated in the future by the governing body who will be voted in for a period of 12 months by all members in good standing. I understand that if accepted into the association of certified psychics that my annual subscription will be due and payable on or before the due date being the date of acceptance into The Association of Certified Psychics.

Singed:_________________________________________________Date:_____________________

Print Name:______________________________________________ Address:__________________________________________________________________________