Affiliate Status Application

Are you joining the BCPA for the first time?
You're entitled to the pro rated affiliation fee. Please call us at 604-730-0501.

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Affiliation renewals for 2022-2023 start on June 1, 2022.

If you are a current affiliate, you will be receiving a renewal letter in the mail.

Affiliation Terms & Conditions

By completing this application, you hereby understand and agree to the following terms:

I understand that affiliate status in BCPA confers no capacity to refer to myself as a psychologist
(Retired Affiliates) I attest to have been registered in good standing with a provincial or state regulatory body previous to my retirement
(Acedemic Affiliates) I hold a doctorate degree in psychology and an academic appointment ta an accredited university/college
(Student Affiliate) I attest that I am currently enrolled in a post-graduate psychology program at an accredited university in British Columbia, Alberta, or Washington State.

Please continue by choosing one of the affiliation options below.

Student Affiliate *

Student Affiliate - $ 52.50 (includes GST of $ 2.50)

Total Amount

Please enter a Username to create an account. If you already have an account please login before completing this form.

Username *

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Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.

Registrant Info

Title

First Name *

Middle Name

Last Name *

Gender *

Female Male Other Prefer not to say

Email *

Registrant Info

Current Employer or School

Street Address (Main) *

City (Main) *

Postal Code (Main) *

Country (Main) *

Province or State (Main) *

Phone (Main) *

Former registration or current student #

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