Online Dues Payment Form

This online dues form is intended for renewing current memberships and reinstating memberships that have lapsed since September 2017. If you were not a member in 2016-2017, please use the member application form instead. MPAGS members - please use the student dues form.


Name:  
Phone Number:
E-Mail Address
Confirm E-Mail Address
Your 2017-2018 Dues Assessment $    (What is my dues assessment?) Psychologist - licensed during 2017: $120
Psychologist - licensed during 2016: $195
Psychologist - licensed during 2015: $250
Psychologist - licensed during 2014: $300 - New!
Psychologist - licensed during or prior to 2013: $350
Psychologist - licensed and 68+: $235
Non-Licensed; Associate; or
            Non-Resident Affiliate: $235
Non-licensed and 68+: $125
Retired: $55

(Please refer to the dues bill you received in the mail.)

Adjustments (if applicable)

Newly Age 68, licensed: $235

Newly Age 68, non-licensed: $125

Disabled, deduct full dues amount

Only Employment is Public/Academic Sector: -10%

Hardship Dues: $60 (Requirements for hardship dues) A hardship dues rate can be taken for 2 consecutive years only. This is privilege for members having financial difficulty due to illness, family difficulties, etc. Part time work is not eligible.

Send note explaining need to members@marylandpsychology.org. No public record of this reduced payment is kept. If applying for hardship dues rate beyond the second year, please contact the MPA office - members@marylandpsychology.org

Newly Retired: $55

Non-Resident Affiliate: $235


Adjusted Dues Total: $
Request Change of Member or Dues Status
(if applicable)

Fellow

Non-Resident Affiliate

Newly Retired

Contributions

Legislative/Advocacy Contribution: $

PAC contribution: $

MPAF Public Education Contribution: $


Cumulative Dues/Contribution Total: $
The Maryland Psychologist newsletter

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Listservs

Add me to MPA-News/ Remove me from MPA-News
Add me to MPA Listserv/ Remove me from MPA Listserv
Add me to ECPN/ Remove me from ECPN

Licensure

Licensed in Maryland? (Date: )
Licensed in Virginia?
Licensed in DC?

Join a Committee
Get Involved

Discover what your active colleagues are doing for you and when they meet on the committees page.

Contact me about getting involved with:

Early Career Psychologists
Educational Affairs
Professional Practice
Communications
Membership
Public Education
Diversity

Contact Information/Directory Update

All information is correct as printed on my dues
Update the following mailing/email address, phone number, etc. (be sure to tell us if it is home or office and indicate which address/phone is being replaced):

Omit the following address from the membership directory:

Note: please complete the Directory Update to make changes to your directory information (occupation, areas of expertise, services offered, etc.)

Installment Billing &
Auto-Renew Membership

If you select either of these options, you will be directed to a secure form to accept your credit card and billing information.


Auto-Renew: Please automatically charge my credit card to renew my dues each year until I direct otherwise.


Installment Fee: $5.00 (Until December 1, 2017)

Your card will be charged for three consecutive months for one third of the Total listed below by the MPA Staff. A $5.00 fee is applied for this service.



Reinstatement Fee

Reinstatement Fee: $40.00 (Applicable as of September 27, 2017)

Total $