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Apply for a student membership
Fill in the application below, along with all your supporting documents, to apply for your student membership.
Name
First name
Last name
Address
Personal Home Address Line 1
Personal Home Address Line 2
Personal Home Address City / Town
Personal Home Address Region
Personal Home Address Post Code
Personal Home Address Country
Contact details
Phone number
Email address
University details
University
Enrolled course
Expected graduation date
Declarations
I hereby apply to become a student affiliate of the New Zealand College of Clinical Psychologists. I also make the following declarations:
I agree to abide by the Rules of the College. *
Have you ever been the subject of any complaint to the Health and Disabilities Commissioner, the New Zealand Psychologists Board or an equivalent overseas body?
Select one
Yes
No
If yes, you agree to provide details of the complaint to the President of the NZCCP and authorise the agency to whom the complaint was made to release all records and information pertaining to the complaint to the President of the NZCCP for the purposes of assessing your eligibility to be a member or associate member of the NZCCP. Please supply details addressed to the President, C/o office@nzccp.co.nz and marked “Confidential”.
The above information is true and accurate. *
Evidence of enrolment
Upload enrolment document
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