The International Society for the Psychoanalytic Study of Organizations

Click here to download an application form in Microsoft Word that you can fill in off-line and send to the ISPSO Administrator (admin@ispso.org).

Application for Membership

Membership in the ISPSO is open to those who share an interest in applying psychoanalysis to organizations.

Annual membership dues are:

Membership Subscription 2016 $ 200 USD (or equivalent in other currencies)
Membership Subscription 2016 for Guest Member, Student Member, Emeritus Member $ 50 USD (or equivalent in other currencies)
Membership Subscription 2016 for New Members who join after the Annual Meeting $ 100 USD (or equivalent in other currencies)

Instructions: Save this form to your computer's hard drive. Open it in Microsoft Word. Fill in the blanks,
save it as a Word document, and e-mail it as an attachment to the Administrator. Applying by e-mail will facilitate the application process. However, if you are unable to email the document, please contact the Administrator for assistance:



Please be sure that you have filled out the Statement of Interest and Brief Biography. Your application will not be processed without them.

Please note that the application approval process takes approximately 3 weeks.


REQUIRED: I am applying for: (place an 'X' on the appropriate place)

Regular membership: Guest Membership: Student Membership:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

REQUIRED: PERSONAL INFORMATION

First/Given: Last/Surname:
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Home Address

Street: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Town or City: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ State/ Province: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
ZIP/Postal Code: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Country: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Home Telephone

Country Code: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

The following two questions (year of birth and gender) are optional. The Board finds this demographic data useful in understanding the evolution of ISPSO; this individual information will be treated as confidential.

Year of Birth: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Gender: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

EMPLOYMENT INFORMATION

Name of Organization/Institution: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Title/Position: _ _ _ _ _ _ _ _ _ _ _ _ _

Employer Address

Street: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Town or City: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ State/ Province: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
ZIP/Postal Code: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Country: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Business Telephone

Country Code: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Business Facsimile

Country Code: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Number: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Other organizations you may work for:

REQUIRED: Email Address where you wish to receive ISPSO email:


UNDERGRADUATE EDUCATION

College / University: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Field of Study: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Degree: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date Received: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

POSTGRADUATE EDUCATION

1)
College / University: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Field of Study: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Degree: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date Received: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
2)
College / University: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Field of Study: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Degree: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date Received: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
3)
College / University: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Field of Study: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Degree: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Date Received: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Please indicate any experience/training you have had in the
following areas:

A. PSYCHOANALYSIS/ PSYCHOTHERAPY:

B. GROUP DYNAMICS:

C. ORGANIZATIONAL CONSULTANCY:


PROFESSIONAL AFFILIATIONS:

PROFESSIONAL HONORS:


REQUIRED: STATEMENT OF INTEREST
The Membership Committee requests that you include in this application any statement you care to make that you believe will be helpful in evaluating your application.


REQUIRED: BRIEF BIOGRAPHY
(This biography will be posted on our list-serve, to introduce you to our members.
It will also be placed on our website, along with the biographies of our current members.)

DE3918|Please write a brief description of yourself covering the following points:##

  1. The kind of work you do;
  2. Organizations you work for or are associated with, along with an account of the roles you hold in them;
  3. Professional training you have had;
  4. Special work interests you have, including particular interests you may have in ISPSO.

LIST OF PUBLICATIONS
(This will also be posted on our website)

To help us better understand our members and the field, please answer the following questions

a. How did you hear about ISPSO?

b. What other professional organizations do you belong to?

c. What journals do you regularly read?

d. What conferences do you regularly attend?


REQUIRED: The membership of ISPSO includes a broad spectrum of professionals. For the next question we ask that you list your primary professional identifications. Please list these in order of time commitment (from highest to lowest percentage time). Please use terms from the following list if possible:

  • Academician/Educator
  • DE3918|Manager/Administrator/Executive
  • Organizational Consultant
  • DE3918|Psychoanalyst
  • Therapist/Counselor
  • DE3918|Other

If you list includes the choice of "Other" please describe this professional role (E.g., physician, financial planner, minister).

Begin list here:

Please be sure that you have filled out the Statement of Interest and Brief Biography. Your application will not be processed without them.

We look forward to receiving your application. Thank you!