Membership Registration Form

Contact Details:

Proffesional Registration: HPC-Industrial Psychologist HPC-Clinical Psychologist HPC-Counselling Psychologist HPC-Research Psychologist SABPP IPM Other

Membership Category: Large Corporate Member Small Corporate Member Individual Member
(for details on categories)

 

Second Contact Person (If Corporate Membership Application):

Name
Position
Telephone (w)
Fax
email

A member of the PAI executive will be contacting you to verify your details and request. Please note that this is for your protection. We will let you have the PAI's deposit details once we have confirmed your details with you. If you have any queries please do not hesitate to contact us.

 

The following document is in pdf format. If you do not have the Adobe Acrobat Reader, you can download it from the following site for free:

http://www.adobe.co.uk/products/acrobat/readstep.html

To download a printable version of this form, please click here

Kindly post this to:
Dr Chris Nunns
P.O.Box 782178
Sandton
2146

Or fax the form to:
+2711 883-8231