Membership Form

Title *

First Name *

Last Name *

Other Title

Email Address *

Work Number

Mobile Number

Fax

Address

Street Address

Street Address Line 2

Apt, Suite, Bldg. (optional)

City

City/Town

State / Province / Region

Zip Code

Zip / Postal Code

Nationality

Country of Origin

If different from nationality

Country

Professional Information

Institutional Affiliation

Position

Your job title

Practice Area(s)/Specialization

Limit 200 characters

Area(s) of Research Focus

Limit 200 characters

Membership Fees 2015-2017

Please select the category which applies to you

Membership Fees *

Full Member | US$100

Associate Member | US$80

Institutional [Affiliate] Membership | US$200

Students* | US$60

*copy of Student ID with picture or letter from Head of Programme required

Payment Method *

PayPal (Pay now via this form)

PayPal Invoice (Pay via Email Invoice)

Wire Transfer (Receive details for wire-transfer)

Eligibility for membership shall be as follows:

FULL Membership shall be open to those individuals teaching (full-time or part-time) in social work programmes in accredited educational institutions in the Caribbean.
ASSOCIATE Membership shall be open as follows:
1. All persons in the Caribbean who are accredited supervisors / instructors of social work students in their field practicum, as well as staff training officers in accredited social service agencies.
2. All persons of Caribbean origin who hold positions as social work educators, practicum supervisors or social work staff training officers in their country of residence.
3. Any other individual (within or outside of the Caribbean) engaged in social work education, as indicated in 1. or 2a. above, who may be recommended for such membership by two full members of the Association.
AFFILIATE Membership shall be open to all organizations in the Caribbean engaged in the provision of training or the setting and maintenance of standards related to the social work profession.

PAYMENT NOTICE
Payments can be done via Paypal or wire transfer. Selecting a PayPal option allows you to pay via a Credit Card or your PayPal account. If your transaction is incomplete you will be sent a Paypal invoice via e-mail. If your PayPal form is in Spanish, Please change the language by clicking Español and selecting your preferred language option.

If you opt not to pay using PayPal you can request the bank details be sent to you to make payment via wire transfer.

Note: Your application is not finalized until payment is made. Wire transfers attract a bank imposed charge of USD$25.

Total

US$

Total