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Associate Membership Nomination Form The Psychonomic Associate is a nonmember affiliate of the Psychonomic Society. Requirements for Associate status are a PhD in psychology or a related field and sponsorship by a member of the Society. Associates receive the Program of the annual meeting and other mailings as may be appropriate. Associates have no vote and pay no dues. However, they are assessed an annual fee. The fee is currently $70, of which $30 may be used as a journal credit; the remainder covers the cost of printing and mailing the material they receive. A check for total fees of $70 must accompany this application. Remittance must be in U.S. dollars, payable to the Psychonomic Society, Inc., in the form of (1) check drawn on a U.S. branch bank account, (2) international money order, or (3) international postal money order. Note that a subscription form is sent to new associates after the initial application has been processed. The $30 journal credit may be deducted from the cost of any journals ordered on that form. NAME _______________________________________________ Present Appointment ____________________ University or Organization __________________ MAILING ADDRESS (include postal code) _______________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Telephone ( ____ ) _________________________ E-mail ____________________________ EDUCATIONAL HISTORY: Highest degree_____________________________ Date awarded _____________________ Field ____________________________________ Institution _________________________ Title of dissertation (and reference, if published) ____________________________________ ___________________________________________________________________________ TYPED NAME AND ADDRESS OF SPONSOR___________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Sponsor's Signature ______________________________________ Date _________________ Return the completed form with payment to the address below. You will be notified when your application has been accepted. Subsequently you will be notified each year of the annual fee and will remain an associate with payment of the fee. Associates are encouraged to apply for regular membership when they believe they are eligible. Mail this form with payment (check, money order, or include MasterCard or Visa information) to:
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