Application for Membership

Contact Information

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Select Date
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Clinical
Counseling
School
Developmental
Other
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Email address will be used as login email address
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This item must be completed for your application to be processed, Find your Legislative District
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Membership Categories and Qualifications

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Please indicate the category of membership you are applying for and the qualifications you meet
Full Member dues based on annual clinical and/or administrative income
Full (Practitioners and Academicians)
Associate - $25.00
Student - $10.00
Member/Fellow status in the APA
Eligible for APA Member status
Doctoral degree of Psychology or closely related field from regional accredited college/university
 
Includes academics with no clinical income
Associate Member of APA
Eligible for APA Associate Member status
Full membership in allied professional organization
Sustaining Membership:- Any member who increases his/her membership investment by an additional $100.00
Support for Legislative Advocacy:- Suggested amount: Equivalent of 1 day's pay.
Sustaining Membership - $100.00
Support for Legislative Advocacy

For Student Affiliate

Background Data

Please attach a curriculum vita or statement outlining your education, professional experience, membership in other professional organizations, licensure/certification/registry status, research, publications, etc.

Login Information

Professional Ethics Declaration

This section MUST be completed

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Please describe briefly the events leading up to the case, the outcome, and its relevance to the practice of psychology. This information will be kept confidential.
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Please describe briefly the events leading up to the case, the outcome, and its relevance to the practice of psychology. This information will be kept confidential.
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No
Please describe briefly the events leading up to the case, the outcome, and its relevance to the practice of psychology. This information will be kept confidential.

Applicant’s Statement

In making this application for NDPA membership, I subscribe to and will support the objectives of the Association — “to advance psychology as a science, as a profession, and as a means of promoting human welfare” – and agree to abide by the ethical principles of NDPA. I hereby absolve NDPA, its officers and staff, Board of Trustees, Members, and Affiliates from damages or any other liabilities resulting from unfavorable action on my application or from disciplinary action or expulsion under the provisions of NDPA bylaws. The statements made in my application are true and complete. I authorize NDPA to contact my references and investigate my credentials. Unless I notify NDPA to the contrary, I authorize my name and address to be made available to outside individuals and organizations as part of NDPA’s mailing list.
 
 
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Total
$0.00
 
10.00 25.00 65, 170,195,220,245,270,295,320,345,370

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