I would like to upgrade/transfer my member type to:

*denotes required field.

Student: Students are those individuals who are matriculated in degree or residency programs, or individuals enrolled in certificate-granting programs in the mental health professions and allied fields.

Name:

Email:

Institution:

Anticipated Graduation Date:

Verification

Please submit verification in the form of a current dated identification card stating full-time status or other confirmation of your full-time enrollment from the institution.