Membership Application

The North Texas Art Therapy Association

Name and Designations____________________________________________________

Email Address____________________________________________________________

Mailing Address__________________________________________________________

City____________________________State_________________Zip________________

Home Phone_______________________ Cell Phone____________________________

Check All that Apply:

I am able to provide supervision for:

___ATR ___LPC ___LMFT ___Other (Specify)____________________

Membership Categories and Fees:

A	Professional ($25 per year): An individual who is an ATR or an active professional member of AATA. Professional members may vote, hold office and serve on committees.
B	Associate ($25 per year): An individual who is a member of AATA, and is interested in the therapeutic use of art. Associate members may not vote or hold office, but may serve on committees with application approval.
C	Student ($15 per year): An individual who is currently enrolled in art therapy or related coursework. Student members may serve on committees with an application approval.
D	Friend ($15 Donation to NTATA): An individual interested in the association’s activities and programs, but is not a member of AATA. Friends may serve on committees with application approval. Dues are payable to NTATA.

For Categories A, B, and C, NTATA dues are payable through your AATA membership.

Please provide proof of membership in AATA

Payment may be sent to:

NTATA, c/o Beth Morale, NTATA Treasurer

9911 Windledge Drive

Dallas, TX 75238