PSAS Membership Application for 2008

 

TO:  Puget Sound Adlerian Society                                                 Date _______________________

        8249 38th Ave. N.E.

        Seattle, WA  98115

 

___  Please renew my PSAS membership for the year 2008, OR

___  This is for a new membership.

___  I can help.  (Please circle one or more of the following:  board membership, monthly Adlerian

        Forums, conferences, the library, the office, occasional help, publicity/PR, grant writing,

        fundraising, Sanity Circus and other parent ed, membership, history, social events, other activities _________________________.)

___  Please send me an application for a new associate or general  membership in our international

        affiliate, the North American Society of Adlerian Psychology (NASAP).   (NASAP handles  

        renewals.)

I am enclosing:

___  $28.00 for PSAS membership for 2008.  Membership offers participation in PSAS business         meetings and social events, discounts on most PSAS-sponsored educational events, e-mail notice      of avail­ability of quarterly issues of The Parenting Calendar, and a 20% discount on most book,

        tape, video, CD, and DVD purchases.  (After July 1, dues are $15.00.)

___  A donation for PSAS.  PSAS is a 501(c)(3) organization; donations are tax deductible.   

        (Donations through United Way are most welcome!)

Total  $_________ .  (Please make your check payable to PSAS.)

 

Name (please print): _____________________________________________________________

Address:  _____________________________________________________________________

_________________________________________________________________________ (zip)

Phones (please include area codes):  _____________________ day, ___________________evening

E-mail address (for event notices, Parenting Calendar notice, etc.):  ________________________

I am particularly interested in:

___  parenting                             ___  counseling                      ___  school counseling

___  teaching                              ___  the workplace                ___  _________________________

Suggestions for subjects for monthly Adlerian Forums:  __________________________________

____________________________________________________________________________

 

Comments, questions:  ___________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

 

Thanks for your interest and support!       The PSAS Board