Membership
Application

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Instructions: Please complete the form providing information for all applicable sections. The information provided will be held confidential and used for the sole purpose of assessing your application for membership within the Society. Please print or scan after completion; sign and return to the Jamaican Psychological Society with the relevant supporting documents.

Personal Details

MEMBERSHIP CATEGORY APPLYING FOR

Mailing Details

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Contact Details

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Highest Psychology Degree Attained

Current Level of Study (If Applicable)

Certification & Licensure

Are you cetified or licenced by a profession psychology board or organization
Has you licence ever been suspended or revoked by a regulatory body?

If yes, please give date

Have you ever been convicted of a crime in Jamaica or any other country?

If yes, please provide details concerning the nature of the offense and the action taken by the court in response to this offense.

Area of specialization and interest

Checklist of Documents Enclosed