OAMHP Membership Application Form Posted July 23, 2018 by Mark Thank you for considering membership with the OAMHP! Please ensure you have read the application information before completing the following Membership Application. Upon submitting your application, application fee, and documents, please allow 7-10 business days to review and process your membership application. The Membership Coordinator may contact you during this time to request further information. First Name * Last Name * Gender * Male Female X Date of Birth ErrorCounter Mailing Address Street * Unit / Suite * City * Province * AB - Alberta BC - British Columbia MB - Manitoba NB - New Brunswick NL - Newfoundland and Labrador NS - Nova Scotia NT - Northwest Territories NU - Nunavut ON - Ontario PE - Prince Edward Island QC - Quebec SK - Saskatchewan YT - Yukon Postal Code * Phone Number * Work Number Email Address * Languages * English French Other Other Language Have you previously been a member of OAMHP or OACCPP or OAPA? * Yes No Why are you interested in joining OAMHP? * Would you like to volunteer with OAMHP? Yes No Are you currently a member of a regulated college (e.g. College of Psychologists of Ontario, College of Nurses of Ontario, etc.)? * Yes No Please confirm your primary practice designation: * Consultant Counsellor Psychometrist Psychotherapist Psychological Associate Psychologist Are you currently a member of another professional association? * Yes No If applicable, please name your current area of specialization (e.g. Anxiety, depression, etc.): Have you ever been disciplined as a member of a regulated college? * Yes No Have you ever been disciplined as a member of a professional association? * Yes No What type of membership are you applying for? * General Affiliate Student Required Documents Please select any required documents you would like to upload now. Alternatively, some/all required documents can be submitted by mail or email after submitting your application. Payment Method * Pay Now via Credit Card Pay by Cheque Pay by E-Transfer Pay with Cash Application Total Total: $ I agree to the terms of payment I acknowledge that I have read and agree to the terms of payment and understand that the OAMHP Application Fee is non-refundable.