ASGPP DIPLOMATE STATUS AND MEMBERSHIP
This application is for granting a Diplomate Status (Domestic or International) of ASGPP.
The candidates must be both,
a/ASGPP members in good standing; AND
b/ ABE certified (CP, PAT or TEP)


Step 1. Please complete and submit this form Online to the national office.

Step 2. Return to the membership payment link page.
To do so, close the current tab you are on after clicking SUBMIT,
and this should automatically return to the tab titled: 'Membership payment link'.
(If it doesn’t return to payment link, then select the tab by clicking on it.)

If you prefer to pay by check print this form and mail with payment to:
ASGPP
301 N. Harrison Street, Suite 508,
Princeton, NJ 08540 USA

Please fill in all fields that are applicable. Please put an N/A in the rest of the fields.

Email address *
Date *
MM
/
DD
/
YYYY
Name *
Your answer
Address *
Your answer
Phone *
Your answer
Degrees *
Your answer
Licenses/Certifications *
Your answer
Present Occupation *
Your answer
ASGPP Member in Good Standing *
Certified by the American Board of Examiners in Psychodrama, Sociometry and Group Psychotherapy (ABE) *
Joining or Renewal *
To make a payment...
... after you submit this application,

Return to the membership payment link page.
To do so, close the current tab you are on after clicking SUBMIT,
and this should automatically return to the tab titled: 'Membership payment link'.
(If it doesn’t return to payment link, then select the tab by clicking on it.)

If you prefer to pay by check print this form and mail with payment to:
ASGPP
301 N. Harrison Street, Suite 508,
Princeton, NJ 08540 USA

A copy of your responses will be emailed to the address you provided.
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