Houston Group Psychotherapy Society

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Membership Renewal

Use the form below to complete your membership renewal (you will be directed to paypal to make your dues payment) or download a printable form to send in.

Please note: beginning September 1, 2018 Dues will increase to $85 per year for Clinical, Affiliate and Friend memberships and to $30 per year for Student Memberships.

Name*
First Last
Credentials*
If your credentials include acronyms other than MSW, LCSW, LPC, PhD, MD, RN, LMFT, LPC, FAGPA, CGP, MEd, or LCDC, please spell out them out.
License Number
Have you had any disciplinary action taken against your license(s)?*
- Yes
- No
Please explain any disciplinary action taken against your license*
Address*
Street Address Address Line 2 City State ZIP Code
Is the address provided your home or office?*
- Home
- Office
Office Phone*
Home Phone
Mobile Phone
Email
Name of Practice
Website address
Please select any committees you may be interested in joining
- Education
- Membership
- Leadership Development
- Finance
- Development
- Publications
- Special Interest Groups
- Continuing Education
- Community Outreach
- Institute
Foreign languages spoken
To better use your skills, please tell us your previous career, if any:
Are you a Member of AGPA (American Group Psychotherapy Association)?
- Yes
- No
Are you fully retired (exempt from dues)?*
- Yes
- No
Publish on Web Site
- Yes, please publish my information on the HGPS web site.
- No, do not publish my information on the HGPS web site.
Membership Type
- Clinical - $85.00 per year - $85.00
- Affiliate - $85.00 per year - $85.00
- Friend - $85.00 per year - $85.00
- Student - $30.00 per year - $30.00
After 9/1/18

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Upcoming Events

Feb 08

Principles of Group Psychotherapy with Jennifer Markey, Ph.D., M.Ed., CGP and Valorie George LCSW, CGP

February 8 - February 9

Apr 25

Spring Institute – Ethics Thursday Evening & Institute Friday & Saturday

April 25 - April 27

Helpful Links

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Contact HGPS

Houston Group Psychotherapy Society

PO Box 22866

Houston, TX 77227

713-668-2680 phone

About HGPS

Houston Group Psychotherapy Society is an affilate of AGPA.

Group listings are a public service of HGPS, and are led by members. Listings are provided for informational purposes only. HGPS does not warrant the appropriateness of any group for any particular individual. Please contact the therapist listed for each group for more detailed information. Inclusion in the listing does not imply an endorsement or statement of quality from HGPS.

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