WORLD ASSOCIATION FOR PERSON-CENTERED AND

EXPERIENTIAL PSYCHOTHERAPY AND COUNSELING 

 

Online application for individual or couple membership including journal subscription

Please complete this form with your personal details.  The form is submitted automatically by email and you should receive an immediate acknowledgment.  Your membership includes a subscription to the Person-Centered and Experiential Psychotherapies Journal .

In this form you may move from field to field using the tab key.

I apply for membership of the World Association:

First Name  
Last Name  
Title(s)  
Postal Address - Number, Street  
Postal Address - district  (optional) 
City  
ZIP/Post Code  
(State and) Country  
Telephone  (optional) 
Fax (optional) 
E-mail Address  
Membership category (Please select)  Single      Couple     Student

Enter the date of your application :   dd/mm/yy

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Copyright © 2007 [WAPCEPC].
Revised: 07/02/07