ABPsi Jegnaship Information Form PROFESSIONAL
The Jegnaship Program is a mentorship program created to help connect student members and professional members of ABPSI. This is often facilitated through monthly correspondence via telephone or e-mail contact. This mentoring initiative is a  way to give back as well as to be connected in the Student Circle. Jegnaship is a vital part of creating and maintaining relationships between students and professionals, as well as a way to enhance our knowledge and skills as future and current professionals.

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Email *
First Name *
Last Name *
Current Mailing Address:
Phone Number:
E-mail Address: *
Preferred Method of Contact:
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Returning Jegnaship participant?
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University Affiliation
What credential level best describes you? *
Please further describe your Professional Affiliation/ Title
I.e PhD Student, License Professional, Faculty, PsyD, PhD
Research/Clinical Interest: *
Expectations from Jegnee:
What do you expect to gain from the jegnaship:
Would you like to work with a jegnee that is located close to you?
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Would you be interested in a jegnaship family:
This would include (1) professional, (1) graduate student, and (1) undergraduate Student.  
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Any other questions or concerns you would like to mention?
Do you know a professional member who would make an excellent Jegna? Please Nominate them.  
If so, click yes to nominate them!
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