NAVIGATION

For Student Members Only: APA Division 20 Printable Student Affiliate Membership Application

Please note that joining Division 20 does NOT automatically join you to our Division listserv. To subscribe to the listserv, please follow the instructions at joinpsya.htm.

If you wish to pay by credit card, visit APA's online membership application. You will need to print this form, and type or print your membership and credit card information, then submit via regular mail. The application and credit card number must be sent via snail-mail, because APA does not currently support on-line secure credit card transactions for membership.
If you wish to pay by money order or check, you may use the convenient fillable form below. Again, it cannot be submitted online, because APA does not currently support on-line secure credit card transactions for membership. You can fill out this application in your browser, and then PRINT IT.

You should mail this application, along with a check or money order for your fee (rate schedule below), payable to APA Division 20, to Keith Cooke, below.
Rate schedule:
- Student Affiliates who elect to receive the journal Psychology and Aging: $25.00 with journal (first year $23.00),
- Student Affiliates who elect not to receive the journal Psychology and Aging: $10.00 without journal (first year free, but you should still mail this application form)

Students who elect not to receive the journal should write "Elect not to receive journal" on this form and remit $10 (ten dollars) only ($0 in their first year).

Please remember to reference your name and APA membership number on your check when you mail it.

Keith Cooke
Division Services Office (Re: APA Div. 20)
American Psychological Association
750 First Street, NE
Washington, DC 20002-4242
Phone: 202-336-6013
Fax: 202-218-3599
Email: kcooke@apa.org

Name:

Address (Street):

City, State, Zip:

Telephone:

APA Membership # (8 digits):

E-mail address:

Membership status (type in one of the following: Non-member*, Associate, Member, Fellow, Student, Other):

* If you are a nonmember of APA, application forms for APA will be sent to you.

For questions about membership in the Division, please contact the Division's Membership coordinator:
Joseph E Gaugler, Ph.D.
Center on Aging, Center for Gerontological Nursing
School of Nursing, The University of Minnesota
6-150 Weaver-Densford Hall
v 1331
308 Harvard Street S.E.
Minneapolis, MN 55455
Phone: 612-626-2485
Email: gaug0015@umn.edu
Fax: 612-626-2359