New Members – Please provide documentation as listed below:
Clinical membership: Proof of Clinical Membership in AGPA OR CGP Certificate and a copy of your current license
OR copy of highest professional degree and copy of current license and Affidavit and two Endorsements and Profile Form (forms available at www.ilgps.org or via email at igpsinfo@aol.com)
Associate membership: Provide copy of highest professional degree and copy of current license and Profile Form
Please read and sign (if submitting this form online, the applicant automatically agrees with the following statement): I recognize that I am obligated to report to IGPS any changes in the status of my license or changes that might affect my membership.
I hereby attest that my clinical license is current and in good standing and that I meet the qualifications for the membership level indicated above. I recognize that I am obligated to report to IGPS any changes in the status of my license or changes that might affect my membership.
Please complete and submit this form, or print and send completing it via snail mail to the address listed below. Please direct any questions to igpsinfo@aol.com
Illinois Group Psychotherapy Society
P.O. Box 28538
Green Bay, WI 54304-5388