Join OSPA Online!

Use this online form to join OSPA now, or to change your membership information. The red asterisk (*) indicates a required field. If you have concerns about sending information through the Internet, fill in the blanks below, print out a hard copy of your application, and then mail it (with your check) to:

OSPA Membership
c/o Brian Craig
2727 Old Fort Road
Klamath Falls, OR 97601

You may also contact our membership chair for the standard paper version of this form. (If your system is properly configured, clicking on the above link will launch an e-mail application with the address of our Membership Chair already put into the "TO" field. If not, you'll have to do all of this manually.)

I WANT TO (check one):

* FIRST NAME:

* LAST NAME:

* ADDRESS:

* CITY:	* STATE: * ZIP:

* JOB TITLE:

EMPLOYER/HIRING AGENCY:

HOME PHONE:

WORK PHONE:

FAX:

* E-MAIL:

Please help us update our membership database: In what year did you first join OSPA?

Are you a member of NASP?

What is your level of education?

Please list membership in other professional organizations (e.g. OEA, CEC, OPA, APA, APA Div16):

Approximately how many students do you serve?

How many years have you been a school psychologist in Oregon?

How satisfied are you in your current position?	If dissatisfied, please explain:

The OSPA membership directory will be distributed to all members in a printed form and via this web site as an Adobe Acrobat® (PDF) file. If there is any information that you do NOT want listed in the directory, please indicate so:

We respect the privacy of OSPA members. We occasionally release mailing lists to organizations that present information that may be of interest to you. If you do NOT want your name included on these mailing lists, please check here:

USE THIS BOX TO PAY AT A SECURE ONLINE SERVICE-->	Click on your membership type: Regular ($40) Student ($10) Retired ($15) Associate ($40) You will jump temporarily to our online funds transfer service, PayPal. (Some browsers may display the PayPal page behind OSPA's - look for it there. Please DO NOT click multiple times on membership type links as that will just confuse matters. Hunt around for the PayPal window first!) If you do not wish to pay with PayPal please print out this form and send it with a check to: Brian Craig 2727 Old Fort Road Klamath Falls, OR 97601
Regular members are currently licensed by TSPC as a school psychologist. Student members are currently enrolled in graduate studies in school psychology full time. Retired members are retired from the practice of school psychology. Associate members support OSPA's goals, may be currently employed in a related professional field, but are not licensed by TSPC as a school psychologist. Associate members may not hold office or participate in voting.

I'd like to help with this committee:

I could help others in the area of:

I'd like to contribute the following amount to the NASP Minority Scholarship Fund! USE THIS BOX TO PAY AT A SECURE ONLINE SERVICE-->	Click on a contribution amount: $1 $2 $5 $10 $25 (Again - look for the PayPal screen hiding behind the OSPA window and DO NOT click multiple times on the donation amounts.) If you do not wish to use PayPal just print out this form and send it with a check to: OSPA Membership c/oBrian Craig 2727 Old Fort Road Klamath Falls, OR 97601

You MUST click the "Send it on!" button for the information to be sent!

Your on-line application will be forwarded to the membership committee. If you are NOT using PayPal to transfer funds, then please send a check payable to "Oregon School Psychologists Association" for the full amount of your dues (and donation to the scholarship fund, if any) to the following address:

OSPA Membership
c/oBrian Craig
2727 Old Fort Road
Klamath Falls, OR 97601

Thank you for supporting your state organization!