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Application for Membership

This form should be used to join the Society or to pay annual dues.

Please complete all information. If you wish to pay by credit card, fill in the application below and click on the "To Pay By Credit Card" button below. The form will be electronically submitted and you will be transferred to a secure server to give your credit card information.

If you wish to send in a check, please PRINT this form, fill it out and send it to the address below with the appropriate fee(s).

Do you want to be listed on our members list on our web site? Yes No
Name: (Last, First, M.I.)
Highest Degree Earned: (degree & field)
Granting Institution & Date:
Current Position Title:		Include on web site? YesNo
Agency:		Include on web site? YesNo
Business Address:		Include on web site? YesNo
Home Address:
Do you prefer information to be sent to your: Home address, or Office address?
Business Phone:		Include on web site? YesNo
Home Phone:
Fax:		Include on web site? YesNo
Email Address:		Include on web site? YesNo
List three areas of specialty or current research interests:
Are you: Applying to become a new member, or Paying annual dues (already a member)

Yearly Dues $50.00 (includes Journal)
Student Membership Dues $35.00 (includes Journal)

If you want to mail a check, print and complete your application and send it with dues to:

Dr. Gary Aumiller
Executive Director
Society for Police and Criminal Psychology
750 Veterans Memorial Highway, Suite 205
Hauppage, NY 11788
(631) 724-5522