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Association for Spirituality & Psychotherapy , Suite 501, 250 West 57th St., New York, NY 10019
[Phone: 212-582-1566] [FAX: 212-586-1272]
E-mail

A N N O U N C I N G

A National Membership Organization

ASSOCIATION FOR SPIRITUALITY & PSYCHOTHERAPY



Polls taken at our previous conferences indicate that there is a large interest in forming a membership organization of those interested in psychotherapy, spirituality and healing. They would like to have an ongoing community of people of like mind and shared values.

The Association for Spirituality and Psychotherapy has been formed to foster and deepen the mutually enhancing, as well as constructively critical, relationship between spirituality, psychotherapy, and healing.

Members receive twice a year copies of Psycho-Spiritual Dialogue, the newsletter of the Association that includes articles, poems, book reviews, schedules of Association events, conferences, and workshops. Eclectic in its orientation, the newsletter functions as an interactive forum for its membership and as a vehicle for open-ended inquiry and exchange of new ideas in the fields of psychotherapy, spirituality and healing.

Membership is open to all individuals with a personal, professional or academic interest in the relationship between spirituality, psychotherapy, and healing. Individuals in health, medical, human services, professions including clergy of all religious affiliations, psychologists, psychiatrists, social workers, educators, lay people and students interested in or actively engaged in spirituality and psychotherapy are encouraged to join.

JOIN TODAY!

Please print, fill out and mail this form
Professional Membership
(includes listing in Professional
Resource Guide) ......................$70.00* 
Student Membership 
(Please include copy of
current valid student ID).............$35.00
Full Membership ......................$50.00
Organizational Membership ...........$110.00
Joint Family Membership..............$100.00
Supporting Membership ...............$150.00
Life Membership ....................$1000.00

PLEASE ENCLOSE CHECK OR MONEY ORDER MADE OUT TO: 
Association for Spirituality and Psychotherapy (ASP)
or provide Credit Card Number, Expiration Date,
Security Code and Signature below

Card Number_________________________ Expiry _________

Security Number ____ Signature ______________________

PLEASE PRINT CLEARLY

Name ________________________________________________

Address _____________________________________________

City ______________________ State ________ ZIP ______

Telephone(home) _______________ Office______________ญญ_

Cell ____________ E-mail ____________________________

For Professional Members and higher please write a one sentence Psychospiritual
Orientation, which will be included in our Profesional Resouce Directory.

_____________________________________________________________________

_____________________________________________________________________

Remember, this is a volunteer organization that relies
on the contributions and participation of its members.
Can we contact you to volunteer for upcoming and ongoing
events? Yes______ No______


Mail to: ASP Executive Director
         Diana Kerievsky
         7 Arrandale Avenue
         Great Neck, New York 11024-1803

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