Membership

Membership in the NIP Professional Association is open to  members of the NIP community, upon payment of dues and agreement to abide by the rules and regulations of the Association.

Click here for a description of different membership types (Associate vs. Full membership).

If you would rather print out the form and fill it in by hand, click here to download the old membership form.

Email questions or problems to nippaorg@gmail.com

 

New Membership Form

To renew an existing membership, please click here.

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Open a guide to the abbreviations used for Affiliation.
 
 

Office 1 Address




 


 
 

Office 2 Address




 


 
 

Home Address




 


 

Directory Listings

Choose one or more selections from the Choices list at right. You can also write in additional panels, one per line.

Your answer (editable):

     

Choices:
 

Write in languages, one per line.
 

Please select up to THREE primary specialties.

ADD/Learning Difficulties

Addiction/Recovery

Adolescents

Adoption

Anxiety/Panic Attacks

Artists/Performers

Bereavement/Grief

Career issues/unemployment

Children/Pre-Adolescents

Chronic pain/Terminal Illness

Cognitive/Behavioral

Couples

Death & Dying

Depression

Divorce

Eating disorders

EMDR

Families

Gay/Lesbian

Gender Identity

Geriatrics

Groups

Hypnosis

Immigration

Infertility/Pregnancy

Parenting Issues

Physical Disabilities

Relationship Issues

Sexual Abuse/Incest

Spirituality

Supervision

Trauma

 

Please select the primary region served by your practice.