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Membership Application Form

Please complete the following membership application. After you have submitted your application, you will be placed in pending status while INS administrators review your application. Once your application has been processed, you will receive an e-mail notification regarding your acceptance into the Society. The e-mail will include information on how to pay for membership dues.

Important-be sure your email address is entered correctly.

Required fields are in red.

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Contact Info

This is the address that will be included in the INS Directory. If you wish to exclude any of your contact info from the online directory, please click on the check-box next to the textfield.

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Professional Organizations of which you are a member

Membership Type*

Regular (Annual dues: $120.00)

Eligibility: Includes qualifications (degrees, certifications, or other requirements) consonant with the profession in the country of origin; and a significant proportion of activities devoted to neuropsychology or closely related fields. Applicants who have completed their training will be considered for this category of membership only. Regular members shall have the power to vote in the Society elections and to hold office.

Associate (Annual dues: $60.00)

Eligibility: Includes current enrollment in an academic program (undergraduate or graduate), an internship program, post-doctoral training program, or residency program. Associate members shall not have the power to vote in Society elections and may not hold office in the Society. Associate members must provide verification of their training status from their academic program director. Please fax or mail the letter to the INS office.

International Neuropsychological Society • 700 Ackerman Road, Suite 625 • Columbus, OH 43202 • 614.263.4200