The Society for the Psychological Study of Masculinity and Men, Division 51, American Psychological Association
volume 11
number 1
  
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  application for membership in SPSMM
 

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Name:__________________________________________________
Address:_________________________________________________
________________________________________________________
________________________________________________________
Home Telephone: (_____)_________-_______________
Office Telephone: (_____)_________-_______________
Email:_________________________@_________________________


APA Membership Status:
__Member/Fellow Associate Member
__Student Affiliate Non-APA Member

APA Membership No.:____________________

SPSMM Membership Status Desired:
__Member (Psychology Doctorate, APA Member/Fellow) • $25
__Associate Member (Associate Member of APA) • $25
__Student Affiliate (Student Affiliate of APA) • $5
__Affiliate (Interested in SPSMM & Non-APA Member) • $25


Sex: __Male   __Female


Race/Ethnicity:
__European-American African-American Hispanic/Latino
__Asian/Pacific Islander American Indian/Alaskan Other

Education

__PhD    __EdD     __PsyD     __MA/MS     __MD     __Other

Make check payable to Division 51, SPSMM. Send application & check to Division 51 Administrative Office, American Psychological Association, 750 First St., NE, Washington, DC 20002-4242.

 
   
     
  Edited by: Mitchell Hicks, PhD