Membership application form

If you are interested in becoming a member, please complete this form and return it to the administrator of the Society of Psychotherapists.  We welcome counsellors, psychotherapists, and anyone interested in those fields, of whatever modality or persuasion.

Society of Psychotherapy

Membership Form  2011/2012

Name—————————————————————————————

Address————————————————————————————–

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Email address: —————————————————————————–

Please tick whichever of the circles apply to you:

Psychotherapist                     o                                                 Trainee      o

Counsellor                              o

Psychologist                          o

Other (please state)

How did you hear about the Society of Psychotherapy?

Do you have any ideas for talks/seminars you would like to attend?

To join please print and fill in this form, enclosing a cheque for £10, made payable to the Society of Psychotherapy and return to:

Digby Tantam,

Chair and Membership secretary

Society of Psychotherapy

C/O NSPC

254-256 Belsize Road

London NW6 4BT

Membership will allow you reduced fee entrance to Society events.

Please note that the membership year runs from 1st. October to 30th. September

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