2018 / 2019 Membership Application FEATURE MEMBER BENEFITS Regular Rate
BCPA Member Rate
Liability Insurance **
BCPA Continuing Education workshops
** Averaged non-member pricing from quotes provided by the insurance broker.
A NEW MEMBER
A RENEWAL MEMBER
CONTACT INFORMATION First Name:
Would you like to participate in the BCPA E-mail Forum?
Mailing Address & Phone Number (not available to the public) Company: Address: City:
Postal Code: Fax #:
Email (required): Referral Service Address & Phone Number (available to the public; for Referral Service members only) Website address: Company: Address: City:
Business Phone #:
Postal Code: Alternative Phone #: BC Psychologist