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Registration and 2010 Membership

This form should be used to register for the 35th Annual Conference of The Society for Police & Criminal Psychology that will be held in Hartford, Conneticut, October 28 - November 1, 2009, and to pay 2010 membership dues, and continuing education fees if applicable.

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 (PayPal) where you will enter your credit card information.

If you wish to send in a check, please complete and submit this application below and then then send a check payable to the "Society for Police and Criminal Psychology" to:

Dr. JoAnne Brewster
Secretary, Society for Police and Criminal Psychology
Department of Graduate Psychology, MSC 7704
James Madison University
Harrisonburg, VA 22807
(540) 568-6107
(540) 568-3322 (fax)
brewstja@jmu.edu

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 (optional):
Are you: Applying to become a new member, or are you Already a member

Conference registration and 2010 membership dues: $250
($200 for the conference plus $50.00 for dues)

Conference registration, 2010 membership dues and continuing education: $280 ($200 for the conference plus $50.00 for dues plus $30 for continuing education expenses)

Student conference registration and 2009 membership dues: $135
($100 for the conference plus $35.00 for dues)

If you want to mail a check, please complete and submit this application below and then then send a check payable to the "Society for Police and Criminal Psychology" to:

Dr. JoAnne Brewster
Secretary, Society for Police and Criminal Psychology
Department of Graduate Psychology, MSC 7704
James Madison University
Harrisonburg, VA 22807
(540) 568-6107
(540) 568-3322 (fax)
brewstja@jmu.edu