Membership Application | International Positive Psychology Association

Pay What You Can - 1 Year Student Membership

If you are facing financial hardship, we want you to know we understand! There is a minimum of $10, but beyond that, please just pay what you are comfortable paying for your one year student membership, and you will receive all of the same benefits.

Please note: All prices are in USD.

Membership Dues

Membership Dues Rate Formula: 1*X

Please enter a number equal to or greater than $10 USD to indicate the amount you are able to pay for your membership.

Value for "X" *

Calculated dues rate: N/A

Contact Information

Email *

Re-enter your email *

Prefix

First Name *

Middle

Last Name *

Suffix

Title

Informal Name

Company *

Address 1 *

Address 2

Address 3

City *

State

Zip Code *

Country

Website

Personal LinkedIn URL

Personal Twitter URL

Personal Facebook URL

Profile Photo

Phone Number *

Fax Number

CCMail

Include me in Broadcast Email *
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Additional Information

How did you hear about IPPA? *

Referral Name:

What is your profession? *

If Other, Please Specify

Education Level: *

Graduation Date (past or future):

Which topics interest you? (Select All That Apply) *

I would like to join the following Divisions:

Clinical Division *

Education Division *

Positive Health & Wellbeing Division *

Positive Arts & Culture Division *

Spirituality and Meaning Division (SMD) *

Work and Organizations Division *

Publish My Info Online *

Students: Upload Verification of Full-Time Student Enrollment Here (.doc, .pdf) Allowed file types: doc,docx,pdf,ppt,pptx,xls,xlsx,txt,gif,jpg,png,jpe

Students: Upload Verification of Full-Time Student Enrollment Here (.jpeg, .png) Allowed file types: doc,docx,pdf,ppt,pptx,xls,xlsx,txt,gif,jpg,png,jpe

Payment Details

Payment Method

Enter the name on the bank account according to the information shown on your bank statement. The account number and routing number can be copied from the lower left corner of the check.

Account Type

Checking

Savings

Routing Number

Account Number

Account Holder Type

Business

Personal

Business Name

Account Holder Name

By submitting payment, I am authorizing International Positive Psychology Association to initiate a single or recurring ACH/electronic debit in the amount indicated from the bank account I designated above. I understand that this Authorization will remain in full force and effect until the transaction is cancelled by me by contacting International Positive Psychology Association, or the ACH/electronic debit is processed from the designated account. I certify that (1) I am authorized to debit the bank account above and (2) the ACH/electronic payment I am authorizing complies with all applicable laws.

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Card Number

Expiration

CSC

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Total Amount Due

Pay What You Can - 1 Year Student Membership

Membership Dues

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