Expert Advisor Signup Form

One time processing fee $99.99 US $0! This gives you a criminal background check, creation of your profile on our site, review and work reference background check. Once your information has been processed (24 hours) you will be able to actively book appointments, using instant chat and start providing your services. Your personal information remains private with PASS. Members will only see full name, titles and your short description provided below.
Therapist Information
Full Name:
Email Address:
Titles:
License Number:
Short Description:
Credentials:
You must upload your resume and any other additional supporting documents. You can select more than one file up to 10 files. Accepted file types are (PDF,JPG,GIF,TIFF,MICROSOFT WORD)		 Your Files:
Contact Phone:
Gender:
Date of Birth:
You must be at least 18 years old to join.
Address:
City:
State/Province:
Country:
Zip/Postal Code:
Time Zone:
 
Profile Information
Username:
Password:
Verify Password:
Rate per Minute in dollars ($1.25) :
Minimum half hour appointments. Your clients are billed for the first half hour if they show or not. PASS has a %26 commission rate on each billed minute. First drop down is dollar value second is cents value. Funds are deposited into your PayPal account once a session has been booked with a member. You are expected to show for your sessions in not doing so you will be banned from the website. Minimum rate is $1.00/minute.
Human Verification Code: Code
Enter Verification Code:
Terms and Conditions: I have read the terms and conditions of the website
Payment Information Not Needed for February we are waiving our $99 signup fee!
First Name:
Last Name:
Credit Card Type
Credit Card Number
Expiration Date
Card Verification Number
What's This?
 
Address:
City:
Province/State:
Postal Code/ZIP:

Total: $99.99 US