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  PLEASE NOTE: This form must only be used for New Members. Please click here if you are renewing your membership Become a PsySSA Member
 STEP 1 : Personal Details

The Psychological Society (PsySSA) is committed to the advancement of Psychology as a Science, as a Profession, and as a means of promoting Human Well Being

Please fill in the fields below (* = required fields):

Title Initials *
Name * Surname *
Identification Number *
Address *
Postal Code *
Work No * Home No *
Cell Number * Fax Number *
Email * Country *
Highest Qualification *
Other * If Registered, Board number *


I, the undersigned, hereby apply for membership of the Psychological Society of South Africa (PsySSA) and undertake to abide by the constitution of PsySSA. I undertake to pay my membership fees, as determined by PsySSA, annually. I also undertake to resign in writing (from PsySSA and/or Divisions) should I no longer wish to be a member, and I accept that my membership fees would not be refunded. I agree that I will be held responsible for membership dues accrued up to the date of my resignation. I declare that the information supplied above is correct and that no relevant information has been withheld.

FOR PROSPECTIVE STUDENT MEMBERS ( to be completed by the head of department)

I, the undersigned herewith certifies that is enrolled as a student at the University of and that she/he is currently registered for the course in Psychology.

All Students please note: To confirm the above, we will require a letter from your university confirming your registration for the above mentioned course and it must be stamped by an official University stamp. You may post this to PsySSA Membership Management, P.O.Box 989, Houghton, 2041 OR email it to membership@PsySSA.com



  STEP 2 : Membership Details


Membership Fees (FROM 01 JANUARY 2010) are as follows
Type Price
Full Member R810
Associate R810
Affiliate R810
Students R190
1st Year Interns R270
2nd Year Interns R410
Foreign $170
Psychometry/Registered Counsellor R460
Please indicate if you are a: *
Full Member
Associate
Affiliate
Students
1st Year Interns
2nd Year Interns
Foreign
Psychometry/Registered Counsellor

 I HEREBY APPLY TO BE A MEMBER OF THE FOLLOWING DIVISIONS:

Clinical
  Type Price
Full Member R150
Associate R150
Student R45
Affiliate R150
None  
Counselling
  Type Price
Full Member R120
Associate R120
Student R60
Affiliate R120
None  
Industrial
  Type Price
Full Member R120
Associate R120
Student R75
Affiliate R120
None  

Research
  Type Price
Full Member R60
Associate R60
Student R10
Affiliate R60
None  

Clinical Hypnosis
  Type Price
Full Member R315
Associate R315
None  

Neuro / Forensic
  Type Price
Full Member R100
None  

Health/Sport
  Type Price
Fulll Member R50
Associate R40
Student R20
Affiliate R40
None  

Psychometry
  Type Price
Full Member R50
Student R30
None  

Educational
  Type Price
Full Member R50
Associate R50
Student R20
Affiliate R50
None  

New Member Enrolment Fee
  Type Price
Full/Assocaute/Affiliate R114
Psychometrists/Re. Counsellor R70
Student Member R38
1st Year Interns R57
2nd Year Interns R85.5
Foreign Member $25
None  


  STEP 3 : Payment Details

Please select your payment option below:

EFT / Direct Bank Deposits

You may deposit directly into our bank account. The details are:

Account Holder: PsySSA
Account: 16-3016-5098
Bank Name: ABSA
Branch Code: 630 805 (Rosebank)

Please fax or post a copy of the deposit slip together with your registration form (address above, fax number + 27-11-486 3266/77).

* Please note: If paying via EFT please utilize your membership number as a reference.

Credit Card

If paying by credit card, please fill in the information below: Credit Card

Please debit my Credit Card:
Credit Card Number:
Expiry:
Cvv:




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