Banner: Left

Ontario Society of Adlerian Psychology

Social Interest ~ Gemeinschaftsgefuhl ~ Community Feeling

Advancing Adlerian Psychology in Ontario

Membership Application

The fields below in gray are mandatory.

Name:
First
Last
 
Address:    
     
City:
Province/State:
Postal/Zip Code:
Country: Canada United States
Telephone:
Home
  Work
  Cell
 
Email:
Organization:
Occupation:
Degree:
Website:

 

I wish to receive e-mail updates
Yes No 

 

I wish to be in the Directory of ONSAP Members (The Directory will contain the names and contact information (i.e. email address, mailing address, telephone number(s) of ONSAP members only). This Directory will be accessible only to other ONSAP members for the purposes of communicating with members.) I give permission for the above information to be listed in the Directory of ONSAP Members on the ONSAP website.
Yes No 

 

I wish to be in the Listserv of ONSAP Members (The Listserv will contain the names and email addresses only of all ONSAP Members. The Listserv is accessibly only to those individuals listed, and all contact information will remain protected by ONSAP. The Listserv will not be used for information unrelated to ONSAP and Adlerian psychology.) I give permission for my contact information to be added to the ONSAP Listserv.
Yes No

 

I wish to be in the Database of ONSAP Members and Friends of Adler.  (The Database will contain the names and email addresses only of all oNSAP Members and Friends of Adler.  The Database will not be used for information unrelated to ONSAP and Adlerian psychology, and it will remain protected by ONSAP.).  I give permission for my contact information be added to the ONSAP Database for the purposes of being updated about events (conferences, workshops, social), memos, meetings, etc.
Yes No

 

I am a NASAP Member
Yes No

 

I accept referrals
Yes No

 
I am an Adlerian Therapist
Yes No
   City:  
  I give my permission for my name and telephone number to be provided to individuals inquiring about an Adlerian Therapist.
Yes No

Membership Type: General Student Affiliate
General Membership: Individuals who are professionals (i.e. counsellors, psychotherapists, teachers, social workers, etc.), parents, retired individuals, parent educators, etc.  They will be able to run for office or have an independent vote.
Student Membership: Students enrolled in an undergraduate or graduate program FULL-TIME.  Applications will not be processed until student status is verified.  To verify, send current registration form or an e-mail from one of your professors or the registrar's office to info@adlerontario.ca or mail it with your application.
Affiliate Membership:  Organizations interested in Adlerian Psychology.  They have full privileges except for voting or serving on the ONSAP Board or committees.  Organizations can send their membership questions to info@adlerontario.ca.

MEMBER INTEREST

(You may select more than one.) Present on Adlerian Topics
Plan Social / Networking / Educational Events
Host Events
Contribute to the Newsletter
Setup or Cleanup for Events
Assist with Fundraising
Help Plan the Conference
Serve on the Communication Committee
Serve on the Conference Committee
Serve on the Cultural Diversity Committee
Serve on the Ed. / Prof. Dev. Committee
Serve on the Governance Committee
Serve on the Membership Committee
Serve on the Social Committee
Serve on a Working Committee

PAYMENT INFORMATION

At the completion of this form (when you click the Submit Application button), you will be redirected to a payment page where you may select the appropriate dues option. You will be asked how you wish to pay -- by credit card or by cheque.  Please note that your applications is not completed until the dues is paid.

Please allow 2 to 3 weeks for processing

THANK YOU FOR YOUR INTEREST AND SUPPORT!

In order to eliminate computer-generated form responses, please enter the characters at the left in the box below.

Address:

240A St. David Street North
Fergus, Ontario N1M 2J7
Email: info@adlerontario.ca


Ontario Society of Adlerian Psychology
© All rights Reserved
Charitable Registration Number: 818913717RR0001