See Article III of the Society's by-laws to determine whether you meet eligibility requirements. If you are eligible and you wish to join, please print this page, fill out the requested information, and send it along with a check to the address at the bottom of the page.
Psychoanalytic Research Society -- Application to renew or join 1996-1997
(Please print)
Name: _______________________________________ Highest Degree: __________
Address: ____________________________________
_____________________________________________
_____________________________________________
_____________________________________________
Work Phone: ______________________ Home Phone: ______________________
APA Status:
Fellow _____
Member _____
Associate Member _____
Student Affiliate _____
Nonmember _____
Division 39 Status:
Member _____
Associate Member _____
Student Affiliate _____
Nonmember _____
Membership: $15.00
Psychoanalytic Research Fund Contribution: ____________
Total: ____________
Is this for:
New membership _____
Renewal 1995-1996_____
Renewal 1996-1997_____
I certify that the information in this application is correct and I hereby apply for (or renew) membership in Section VI of APA Division 39, the Psychoanalytic Research Society.
Please mail this completed application with your check made out to APA, Division 39, Section VI to:
Joe Turkel, Ph.D., 6 West 77th Street Suite 1B, New York, NY 10024