PSAS Membership Application for 2009

TO: Puget Sound Adlerian Society                                                 Date _______________________

        8249 38th Ave. N.E.

        Seattle, WA  98115

___  Please renew my PSAS membership for the year 2009, OR

___  This is for a new membership.

___  I can help with (please circle one or more of the following): Sanity Circus or other parent ed,

        membership, a presentation at an Adlerian Forum, the library, the office, occasional help,

        publicity, fundraising, history, social events, other activities __________________________.

___  Please send me an application for a new associate or general  membership in our international

        affiliate, the North American Society of Adlerian Psychology (NASAP).   (NASAP handles  

        renewals.)

I am enclosing:

___  $30.00 for PSAS membership for 2009.  Membership offers participation in PSAS business         meetings and social events, discounts on most PSAS-sponsored events, e-mail notice of availa-         bility of quarterly issues of The Parenting Calendar, and a 20% discount on most book, tape, CD,   and video purchases.  (After July 1, dues are $20.00.)

___  A donation for PSAS.  PSAS is a 501(c)(3) organization; donations are tax deductible.   Our   

        budget needs your help!   (Donations through United Way are also welcome!)

Total  $_________ .  (Please make your check payable to PSAS.)

Name (please print): _____________________________________________________________

Address:  _____________________________________________________________________

_________________________________________________________________________ (zip)

Phones (please include area codes):  _____________________ day, ___________________evening

E-mail address (for event notices, Parenting Calendar notice, etc.): __________________________

I am particularly interested in:

___  parenting                             ___  counseling                      ___  school counseling

___  teaching                              ___  the workplace                ___  __________________________

Suggestions for subjects for monthly Adlerian Forums:  __________________________________

____________________________________________________________________________

Comments, questions:  ____________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

Thanks for your interest and support! The PSAS Board