APA Membership Renewal Application

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Please complete the application below to renew your APA membership. All submitted applications are reviewed and verified.

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APA Membership

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	$145/yr	Standard Member
	$170/yr	International Member ($145 +$25 for postage)
	$2500	Life Member (never pay dues again)
	$45/yr	Student Member (must be enrolled 9 credit hours and submit proof of student status)


	$145/yr	Diplomate Member
	$170/yr	International Diplomate Member
	$2500	Life Diplomate Member

Payment Information

Payment plans are available for Life Membership. A minimum down payment of $250 (non-refundable) must be made with this application and a minimum monthly payment of $100 must be made. Your certificate will be issued upon full payment.

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Terms of Agreement

I certify that the above information is true and correct, and I am not misleading or providing false information to the American Psychotherapy Association (APA). I may be asked to provide additional documentation. I understand that APA reserves the right to verify any and all information on this application. If I would misrepresent my credentials, refuse to provide documentation at a later time if asked, or allow my membership in the APA to lapse, I understand and agree that my membership will be revoked. I agree to hold harmless and indemnify the APA and its officers, directors, employees, and agents for any misrepresentations of my credentials and for all claims, loss, damage, judgment, or expense. I certify that I have not been convicted of a felony. I have not been disciplined for any ethical violation in the past 10 years, nor am I under investigation by any legal authority or licensing board.

APA does not endorse, guarantee, or warrant the work or opinions of any individual members. Membership does not imply licensing by the organization of a member's qualifications, abilities, or expertise. The objective of APA's publications and the activities that is sponsors is for educational purposes. The views expressed by the authors, publishers, or presenters are their own and do not necessarily reflect those of APA. APA does not assume any responsibility or liability for its members or subscriber's efforts to apply or utilize the information, suggestions, or recommendations made by the organization, publication resources, or activities.

I certify that I have read the above statement and agree to all of its terms

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American Psychotherapy Association
2750 E. Sunshine St.
Springfield, MO 65804
(800) 205-9165
(417) 823-9959 fax
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