Membership Form | JamPsych

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Jamaican Psychological Society

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Membership
Application

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.

Personal Details

MEMBERSHIP CATEGORY APPLYING FOR

FULL (MASTERS OR DOCTORAL DEGREE IN PSYCHOLOGY OR COUNSELLING)

STUDENT (CURRENTLY A STUDENT ENROLLED IN A PSYCHOLOGY OR COUNSELLING PROGRAM AT ANY LEVEL)

AFFILIATE (FIRST DEGREE IN PSYCHOLOGY OR COUNSELLING OR MASTERS OR DOCTORAL DEGREE IN A PSYCHOLOGY RELATED FIELD)

INTERNATIONAL AFFILIATE (M) (MASTERS OR DOCTORAL DEGREE IN PSYCHOLOGY OR COUNSELLING – LIVING IN A COUNTRY OUTSIDE OF JAMAICA)

INTERNATIONAL AFFILIATE (B) (FIRST DEGREE IN PSYCHOLOGY OR COUNSELLING OR MASTERS OR DOCTORAL DEGREE IN A PSYCHOLOGY RELATED FIELD – LIVING IN A COUNTRY OUTSIDE OF JAMAICA)

Mailing Details

Contact Details

Highest Psychology Degree Attained

Highest Psychology Degree - Title of Degree

Highest Psychology Degree - Country

Current Level of Study (If Applicable)

Current Level of Study - Title of degree

Current Level of Study - Country

Certification & Licensure

Are you certified or licenced by a profession psychology board or organization

Yes

Has you licence ever been suspended or revoked by a regulatory body?

Yes

If yes, please give date

Date Started

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

Yes

Nature of offense details

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

Area of specialization and interest - Details

Checklist of Documents Enclosed

Diploma(s) - copy certified by J.P

Upload supported file (Max 15MB)

Valid proof of enrollment (required for student applicants ONLY)

Upload supported file (Max 15MB)

Resume (listing all specialized training & membership in organizations)

Upload supported file (Max 15MB)

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Jamaican Psychological Society

Membership Application

Membership
Application