Join NJ-ACT

To join NJ-ACT, you must be licensed for independent practice in New Jersey; hold a permit to practice psychology in New Jersey; or be licensed for independent practice in another state and live in New Jersey.

New members must mail or email a membership application. You may pay online or mail in your check.

Recurring Payment Option


Your credit card will be charged $8.75 every 3 months until you tell us to terminate your NJ-ACT membership.

One-Time Payment Options

Join through April 30, 2018 ($40):
Join through April 30, 2019 ($80): 

New members, please copy, paste and email the following to info[at]nj-act[dot]org or print out the application below and mail it to:

NJ-ACT c/o Lynn Mollick & Milton Spett
1150 Raritan Road – Ste. 101
Cranford, NJ 07016

NJ-ACT New Member Application

I am licensed for independent practice in New Jersey or I hold a permit to practice psychology in New Jersey or I am a NJ resident, licensed in another state.

_____ I have paid online

_____$80 is enclosed for a NJ-ACT membership through April 30, 2019.

_____$40 is enclosed for a NJ-ACT membership through April 30, 2018.

Name and Degree ________________________________________
Office County ____________________________________________

Permitted or Licensed As: __________________________
License/Permit Number ____________________________

Primary Office Address:

___________________________________________________________________________
Primary Town ___________________________________ State ____ Zip ________
Primary Phone (____)_________________ Email* _______________@__________

Secondary Office Address:

___________________________________________________________________________
Secondary Town ________________________________ State ____ Zip ________
Secondary Phone (____)_________________
Secondary Office County ______________

*We must have your e-mail address to send you our PDF directory, summaries of research studies, member discussions, and notices of opening and closing dates for workshop registration.

Do you want your private practice(s) to be listed on our website Member Directory? (members licensed for independent practice only, please check one)

____ Yes, a complete listing – street address, town, and telephone number.

____ Yes, a partial listing – town and telephone number, without street address.

____ No website listing, please.

To be listed in our website member directory sign and mail or email the following statement:

“I affirm that my profession’s licensing board permits me to practice independently and without restriction, and there is no complaint against me pending with my licensing board. I also agree to inform NJ-ACT immediately if any of these stipulations change.”

____________________________________________ ____________
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Continuing Education in Empirically-Supported Psychotherapy