ASPP 2024 Membership Form

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ASPP 2024 Membership Form

Enter your information below. Fields with asterisks are required for Membership. Additional information may be provided for inclusion in our members-only private practice directory.

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* Indicates required question

Email *

Your email

First Name *

Your answer

Last Name *

Your answer

Credentials
*

Your answer

Phone Number *

Your answer

Membership Category *

Active/Associate/Affiliate/All Clinicians, including Advanced Candidates - $100

Joyce Bloom Candidate Membership / Candidates Taking Classes - $0

Out of Town / Clinicians Outside of New York Metro Area - $50

Supporting / Non-Clinicians Only - $50

Student / Graduate Students in a Mental Health Field - $0

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