FREE BOOK AND DISCOUNT FOR NEW MEMBERS OF DIVISION OF HUMANISTIC PSYCHOLOGY

MEMBERSHIP APPLICATION*

Division of Humanistic Psychology, Division 32 of APA

MEMBERSHIP APPLICATION*

Division of Humanistic Psychology, Division 32 of APA

*Membership in APA is not required to join the Division of Humanistic Psychology
BONUS! New members will receive a free copy of Fadiman and Frager's Personality and Personal Growth (2002) Prentice Hall- a $105 value.

Please print clearly or type:

Name______________________________________
E-mail______________________________
Address_______________________________________________________________________
City_____________________________________State_______Zip code___________________
Highest degree______________________________________
Date awarded________________
Field___________________________Institution____________________________________
APA status ______Member/Associate/Fellow ______Affiliate ____Student Affiliate ____None

If currently a student, please indicate where and what program:
Institution______________________________ Program________________________________
Dues rates:

Members, Fellows, Associates, & Affiliates $35.00
First Year Membership for APA, AHP, ADPCA, WAPCEPC, BAPCA $28.00
Student Affiliates $20.00

Discount Memberships: I certify that I am an active member of __APA__ AHP__ADPCA __WAPCEPC__BAPCA
If paying by credit card:
Cardholder name (name appearing on credit card)______________________________________
Cardholder billing address_________________________________________________________
Credit card number____________________________Card expiration date__________________
Card type: ____Mastercard ____Visa ____American Express
Daytime phone number_________________________
E-mail____________________________
Amount to be charged in US dollars______Cardholder signature__________________________
You may also join Division 32 by calling APA directly at: 202-336-5583

If paying by check:
Please enclose a check payable to "Division 32" and mail with completed application to:

Division 32 Administrative Office
American Psychological Association
750 First Street, NE
Washington, DC 20002-4242

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