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Membership
Membership Application
Note to All Members who are either APA members or eligible for APA Membership: All applicants who are eligible for APA membership must also become members of APA. ALL members of the Division must join Division 39 directly the first time, through the following process. Once membership to the Division is complete, Division dues will be charged on the APA annual membership renewal forms.
You can fill out the membership application and submit it online. If you prefer not to use the online option, please enter the requested information, print, and mail it in with a check or money order in order for your membership to be activitated.
Division of Psychoanalysis
2615 Amesbury Road
Winston Salem, NC 27103
Phone: 336-768-1113
Fax: 336-768-4445
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| Last Name* |
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| First Name* |
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| Highest Degree |
Year degree received: |
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| Are You Currently a Candidate? |
Yes.
No.
If yes, where? |
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| Are You Currently a Post Doc? |
Yes.
No.
If yes, where? |
Primary Address* |
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| City* |
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| State* |
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| Zip* |
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| Telephone |
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| Fax |
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Email* |
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Foreign Language Fluency |
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| Please Provide Your APA #* |
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Those individuals who qualify as a Non APA Regular Member, Allied Professional, International Affiliate, or Student do not need to enter an APA number.
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States Licensed In |
-- AK AL AR AZ CA CO
CT DC DE FL GA HI IA
ID IL IN KS KY LA MA
MD ME MI MN MO MS MT
NE NC ND NH NJ NM NV
NY OH OK OR PA RI SC
SD TN TX UT VA VT WA
WI WV WY PR ON QC BC
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Section Affiliations |
I II III IV V VI VII
VIII IX X |
State Associations Affiliations |
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For Member's Only features
Type a Password* |
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| Retype Password* |
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Check One*:
Regular Member ($95.00)
To qualify for this category you MUST be a member of APA as a Fellow or Regular Member and meet the APA membership criteria, OR you may be a doctorate level psychologist, licensed in your state of province, who does not meet the APA membership criteria.
Allied Professional ($95.00)
Associate Member ($95.00)
To qualify for this category you MUST be a member of APA as a Associate Member and meet the APA membership criteria, OR you may be a doctorate level psychologist, licensed in your state of province, who does not meet the APA membership criteria.
Regular Member (non-APA) ($95.00)
International Affiliate ($65.00)
This status is reserved for international Members of APA.
Student Member ($25.00)
Student status is reserved for those applicants who are Affiliate Members of APA and/or graduate students in a mental health discipline.
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© Division of Psychoanalysis, 1999-2003
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