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Student Member and Application

 
 
STUDENT MEMBER
 
APPLICATION MATERIALS AND PROCESS:
 
·       The materials for making application for the Student Member category include the following: 
 

AAPC Code of Ethics*
Application Form

 
 
·       Carefully follow the instructions contained in the application form. If you have questions, concerning the completion of the application and/or required documentation, contact the Association Office.
 
·       Mail ONE collated, unstapled copy of the completed application, INCLUDING ALL SUPPORTING DOCUMENTATION, along with the appropriate Processing Fee, to the Association Office. Make an additional copy of the application for your records. Faxed applications will not be accepted. NOTE: The Association Office assumes no responsibility for collecting or copying application materials.
 
·       Complete membership applications and supporting documentation will be reviewed upon receipt in the Association Office. Applicants will be notified if documentation is missing. Applications incomplete after six months will be closed.
 
·       Applicants will be notified as soon as a decision has been reached on the application.
      
     FEES:
 
·       The one-time fee for Student Member is $50 and must accompany the application.  
·       NOTE: Student Fees are not refundable. There are no annual dues assessed to student members.
 

    ASSOCIATION OFFICE:

 
·       Send all application materials to:
American Association of Pastoral Counselors
9504A Lee Highway
Fairfax, VA 22031-2303
703-385-6967
 
          *Available on our web page: www.aapc.org. Go to the link to Membership.

 
 
     STUDENT MEMBER
 
 

I.     STUDENT MEMBER

 
The Student Member is a general membership category for students enrolled in an AAPC approved training program, a seminary or an academic program – undergraduate or graduate. Applicants should have an inquiry level of interest in the field of pastoral counseling.
 
Student Member is a temporary status. It is valid only while enrolled in a degree program and for 1 year past graduation.
 
As a Student Member, you will:
 
1.   Pay a one time fee of $50.00 but no regional dues.
2.   Have online access to Currents and Journeys.
3.   Be welcome to attend Association and Regional meetings without the privilege to vote
       or to hold office.
4.   Be eligible to apply for need-based conference scholarships.
5.   Be eligible for discounted rates on your professional liability insurance.
 
 

II.    STANDARDS

 
To qualify as a Student Member, an applicant must meet be currently enrolled in an AAPC training program, a seminary or degree program.
 
·       Submit current evidence of student status.
 
 
 

III.   APPLICATION REVIEW PROCESS

 
Association office staff in Fairfax, Virginia, will process, review, and approve applications for Student Member using consultation with the Regional Certification Chair as necessary. 
 
 
  
AMERICAN ASSOCIATION OF PASTORAL COUNSELORS
 
STUDENT MEMBER APPLICATION
 
(Please PRINT/TYPE all information clearly)
 
Date                                    AAPC Member No.                              (if applicable)
 

I.      PERSONAL

 
 

Name                                                                                                                      

                (Last)                                    (First)                           (Middle)
 

Official Mailing Address:                                                                                             

 

                                                                                           

 

                                                                                         

           (City)                          STATE)   (Zip - 9 digit)
 
Phone Numbers (indicate whether office (o) or home (h):
 

Primary                                              Secondary                                           

 

Fax No:                                        E-mail Address:                                

 

Date of Birth                       Gender                 Religious Body                            

 
Race: (For Demographics)          
Caucasian _____   African American______   Asian_______   Hispanic_______ Other______________
 
Have you ever been under disciplinary action by any professional organization or licensing board, or have you ever had a felony conviction?         YES          NO       If yes, please attach a brief description of the issue and the action taken.
 

II.     PRESENT STATUS

 

 School                                                                               Date Began                    

 Address                                                                                                                                  
                                                                                                                                        
 Currently enrolled in (program)                                                                                   
 Expected date of graduation                                                                                        
 Faculty advisor/supervisor                                                                                            
SUBMIT DOCUMENTATION OF STUDENT STATUS: Documentation may be a current transcript, statement from a school official or other documentation showing the courses you are currently attending

                                                                                                                         



III.  PREVIOUS ACADEMIC PREPARATION
A.   College                                                                                          

                   Degree                                Year                   Major                                       
 
B.   Seminary                                                                                                          

                 
                      Degree                                      Year                  Major                                   
 
C.   Graduate                                                                                                             

 
Degree                                     Year                   Major                                       

  
NOTE: Include transcripts for all claimed degrees.. For student membership you may attach “student copies” of transcripts to this application. NOTE:  Official Transcripts are required for all other membership categories and will be required when you move to another membership level.

  
IV.  PASTORAL COUNSELING INTEREST

 
Student Member is an inquiry level of membership. List your past and current involvement with pastoral counselors and/or pastoral counseling centers, if any. Describe the nature of the involvement.
 
                                                                                                                            

 
                                                                                                                                                                                           
 
 

V.   STATEMENT OF COMPLIANCE

I understand the responsibilities and obligations of membership in the American Association of Pastoral Counselors and agree to abide by its Code of Ethics, and to pay dues and submit reports as required to remain in good standing.
 
I also understand that personnel of the Association will review and act upon this application, and I agree to hold such personnel, the Association, and its officers and agents harmless with respect to action they may take in connection with such review.
 
I also understand that the fee is non‑refundable.
 
                                                                                         
    Date                         Signature
 
        Please send ONE Set (collated, no staples) of the application and all documentation? 
 
For Credit Card Payment:   
      MasterCard              Visa               American Express             Discover                             Payment: $50.00
                     
           Credit Card Number                                  -                         -                           -                                
             Exp. Date        /          /              
              Security Code on Back of Card 3 or 4 Digits                            
 
Print Name as it appears on Credit Card                                                                
Billing Address:           ______________________________________________________
 
                                    ______________________________________________________