AAP Membership Registration Form



Annual Membership Fee: $75.00
Extended 2-year Membership: $140.00
Extended 3-year Membership: $200.00
Organization / Center / Agency Fee (non-voting): $75.00
Student Membership $30 (2-year limit) : $
Sliding Scale Fee $45-75: $
Additional Donation (tax-deductible in the US): $

Total Due   

$

Name:
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(PhD, PsyD, MD, LCSW, MFT, LPC etc.)
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we do not print, please indicate here:




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