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Join NJ-ACT

Learn about Member Benefits

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

Everyone must mail or email a membership application.

 You may pay online or mail in your check.

Click "subscribe" for a

3-Month Trial Membership - $8.75

Only available online

You may cancel this membership at any time by emailing us at NJACBT@aol.com .

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

$80 for a NJ-ACT two-year membership through April 30, 2015.
$40 for a NJ-ACT one-year membership through April 30, 2014.

Please copy, paste and email to NJACBT@aol.com or print out the application below and mail it to

NJ-ACT, P.O. Box 2202, Westfield, NJ 07091.

NJ-ACT Membership 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 two-year membership through April 30, 2015.

_____$40 is enclosed for a NJ-ACT one-year membership through April 30, 2014.

 

Name and Degree ____________________________________________   Office County _____________

                    Permit or Licensed As: ____________________________   License/Permit Number _________________

                    Primary Office Address ___________________________________________________

                    Primary Town   ________________________________   State _____    Zip __________

                    Primary Phone   (____)_____-_______   E-mail*_________________@_____________

                    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.

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

 View directory 

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.

 “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.”

 

                         ____________________________________________     ____________   

                                                                     Signature                                                    Date

                                                                 

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