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NMATA MEMBERSHIP APPLICATION--2004
Membership information provided on this
form will appear in the 2004 NMATA
Directory for networking purposes for members, as well as provided to art
therapy and related agencies and organizations.
--Check here if you do not want your
member information included in the 2004
NMATA Directory
Check all that apply:
__New Member
__Renewing Member
__Concurrent AATA Member (dues for both AATA & NMATA have been sent to AATA)
Name:
Credentials:
Degree/Major:
Date Received/Schools attended:
Address:
City, State, Zip code:
E-mail:
Fax number:
Employment Information:
ATR s & ATR-BCs: Please indicate if you can
provide supervision:
__yes __no
EMPLOYMENT INFORMATION:
Place of Employment:
Position/Job Title:
City, State, Zip Code:
Contact Phone Number:
Population:
(if you have another place of employment)
Place of Employment:
Position/Job Title:
City, State, Zip Code:
Contact Phone Number:
Population:
Levels of Membership:
PLEASE CHECK THE APPROPRIATE LEVEL OF MEMBERSHIP:
__CREDENTIALED PROFESSIONAL: Individuals approved for professional
membership and granted registration (A.T.R., A.T.R.-BC) by the Art Therapy
Credentials board. Credentialed Professional members may vote, hold office,
and serve on committees. Concurrent membership in AATA is required. Dues are
$30.00 per year, payable in January. (Note: If you have sent your extra
Affiliate Chapter $30.00 to AATA with your AATA renewal, you are in this
category). You will receive all mailings and free admission to
NMATA-sponsored events.
__PROFESSIONAL: Individuals having
completed professional training in Art
Therapy and are eligible for Active Professional Membership. Active
Professional Members receive official publications, are eligible to vote,
serve on committees, and hold office. Concurrent membership in AATA is
required. Dues are $30.00 yearly, payable in January. Will receive all
mailings and free admission to NMATA-sponsored events.
__AFFILIATE: Allied professional
(non-art therapists), who are interested in
the therapeutic use of art and creative process. Dues are $20.00 per year,
payable in January. Will receive mailings and free or discounted admission
to NMATA-sponsored events.
__STUDENT: Individuals, not qualifying
for professional membership, who are
currently taking courses in Art Therapy or a related field. Student
verification is required. Dues are $20.00/yearly, payable in January. Will
receive mailings and free or discounted admission to NMATA-sponsored events.
__FRIEND: Individuals, organizations,
institutions who are supportive of the
aims and goals of the NMATA. This category is for non-professionals and
non-art therapists. Dues are $20.00 per year, payable in January. Will
receive mailings and discounts to NMATA-sponsored events.
Send completed membership application with amount (or
verification that you
have already sent dual payment to AATA) to: NMATA, University Station, P.O.
Box 40686, Albuquerque, NM 87196-0686. Call Luanne (922-9548) to see if you
are on the AATA list of concurrent AATA/NMATA members.