Assoc Membership renewal form 2012 by It1M1gjf

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									   The Irish Analytical Psychology Association Ltd.
                              www.jungireland.com

                          Associate Membership 2012

Associate Membership is open to those interested in the work of C.G.
           Jung and in furthering the aims of the IAPA.

Name: ……….…………………………..                               (Block capitals)
Address: ……..…………………………..
       .………………………………...
          …………………………………
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Telephone (landline)………………..                       (mobile)……………….
Email ………………………………


OCCUPATION ……………………………....

SIGNED: ………………………..                                  DATE: ………………..

PLEASE RETURN COMPLETED FORM WITH A CHEQUE FOR €50, MADE OUT TO IAPA, BY
31ST JANUARY 2012 TO:
Membership Secretary
RUTH KEARNEY, 5 BEECHLAWN, SOUTH HILL AV., BLACKROCK, CO.
DUBLIN.

REMINDER: AN ASSOCIATE MEMBER MAY NOT USE MEMBERSHIP OF THE IAPA AS ANY
INDICATION OF A PROFESSIONAL QUALIFICATION OR TRAINING, NOR CAN IT BE USED ON
LETTERHEADS OR AFTER ONE’S NAME.



THE IRISH ANALYTICAL PSYCHOLOGY ASSOCIATION LTD., DUBLIN REG. NO. 253243, CHY 12217

								
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