Maine Psychological Association 2008 Renewal Form

Renew your MePA membership by credit card today!  Please complete and submit this form by February 1, 2008.  Also, please update your practice information by clicking Update Profile in the top menu.  ( * = Required Fields)

After submitting this form you will be redirected to MePA’s secure page where you will submit your credit card information.

First Name *
 Last Name *
Primary E-mail Address *

PAYMENT CATEGORIES *
Check the category that reflects your payment.  Renewal fees increase after February 1.

Full Member (voting)
$265 (Paid before February 1) Income (from psychological work) > $30,000 per year
$225 (Paid before February 1) Income (from psychological work) < $30,000 per year

Academician/Researcher (Voting)
$85 (Paid before February 1) Employed in a full-time faculty or research position and do not engage in private practice

Associate (Votes after 5 years)
$75 (Paid before February 1) Master's degree in psychology or completed at least two years of graduate work

Retired
$65 (Paid before February 1) Members who are retired
$ 0 Any Fellow, Member, or Associate who has reached the age of 65 and has been a member of MePA and/or the APA for at least 25 years, or regardless of age or length of membership who has been adjudged totally and permanently disabled, or at the discretion of the Policy Council, shall be exempt from dues. Although such members shall be exempt from paying dues, they shall retain other rights and privileges of the Association.

Affiliate
$40 (Paid before February 1) Student or former member who no longer meets “Member” requirements, or a psychologist who resides or works out-of-state.

Deductibility
     Association dues are not deductible as a charitable contribution, but may be deducted as an ordinary business expense. MePA estimates that for 2005, 13% of dues will be allocated to lobbying expenditures, and are not deductible for federal income tax purposes. (IRC Sec 162(e)(3).


ADDITIONAL INFORMATION

Media Contact
     Please indicate any psychological topics about which you would be
willing to speak to the media.



Committees/Subcommittees
     I would like more information about the following committees:
Public Education
Women in Psychology
Legislative
Continuing Education
Peace and Social Justice		 Ethics
Membership
Prescription Privileges Task Force
Reimbursement Oversight


Comments/Suggestions?

REFERRAL SERVICE
     After submitting your payment, please update your practice information by clicking Update Profile in the top menu.



Return to this page to donate to PsyPAC below.  (The donation to PsyPAC is a separate process.)

PsyPAC DONATION


Please accept my donation to PsyPAC, the political action committee for Maine psychologists, in the amount of:  $*

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 Last Name *
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