MEMBERSHIP APPLICATION

Membership in the AADCAP is restricted to child and adolescents psychiatrists who are division, section or free-standing department directors of child and adolescent psychiatry within or affiliated with an accredited medical school in the U.S. or Canada. Any individual who ceases to be a director shall cease to be an Active member. If an individual has had a cumulative five years as a Member, he or she may request a transfer to Emeritus Member status.

Please include a letter from the Chair of the Department of Psychiatry or Dean of the School of Medicine verifying your directorship of the program (a template has been provided for your convenience). Beginning in 2020, dues are $300 (Active) /$200 (Emeritus) for the calendar year; if applying after July 1, dues are one-half of the full year. Complete and "Submit" this form or email it to info@aacap.org (all fields are required):

Name*
Title*
Institution*
Mailing Address*
City*
State*
Zip code*
Phone Number*
Fax Number*
Email Address*
Please check all that apply to your position in your division*Division Director   Division Director and Residency Training Director   Director of Psychiatry   
Payment type*Check (payable to AADCAP)   Credit Card   
Credit Card Type*Visa    MasterCard   
CVV*
$
Credit Card #
Exp. Date:*
Name on Card*
Signature*
Billing Address information*
Anti-spam code*
 

 

Please "Submit" or email this form plus your letter of verification to info@aadcap.org.  Payments can be made via PayPal or by sending a check made payable to AADCAP.  If mailing paperwork and/or payment, please send to Earl Magee, AADCAP Executive Director, 5903 Mount Eagle Drive #917, Alexandria, VA 22303.  Email: info@aadcap.org

Thank you!