DVAPT Membership Form
(Please type or print clearly)
Print form and send it with the appropriate dues amount to:
DVAPT
704 Buck Lane
Haverford, PA 19041
First Name:___________________ Last Name_______________________
Mailing Address:
Street Address_________________________________________________
Apartment or Unit Number ___________________________________________________
City________________________ State________ Zip Code_____________
Phone___________________________________
Cell Phone_______________________________
Email Primary_____________________________@___________________
Email Secondary___________________________@___________________
Is it "okay" to share your email address with DVAPT members? Yes ________ No __________
*We promise not to sell or share your information with anyone outside of DVAPT
What is your preferred method of contact? _____________________________________________________________
As a chapter member, you will also become an “Affiliate Member” of APTi
DVAPT membership fee: $45.00** Please enclose a check payable to “DVAPT” and mail to:
DVAPT
704 Buck Lane
Haverford, PA 19041
**If you already belong to APTi, you may add chapter membership by sending
documentation and a check for $30 payable to “DVAPT”. Please also respond
to the following:
I joined APT International for the membership year through (date) _____________.
I joined as a:
“Professional Member” (paid $110 to APTi)
“Retired Member” (paid $75 to APTi)
“Student Member” (paid $55 to APTi)
Are you a NEW DVAPT member______ or a Renewing DVAPT member _____?
How did you hear about DVAPT? ____________________________________________________________________
Are you qualified / certified to administer the MBTI? _____________________________________________________
If you are not currently qualified / certified - do you plan to become qualified or certified? _______________________
What is your profession? ___________________________________________________________________________
Are you currently a student? ________________________________________________________________________
Are you currently "in transition?" _____________________________________________________________________
Content copyright 2012-2023. DVAPT. All rights reserved.
(Please type or print clearly)
Print form and send it with the appropriate dues amount to:
DVAPT
704 Buck Lane
Haverford, PA 19041
First Name:___________________ Last Name_______________________
Mailing Address:
Street Address_________________________________________________
Apartment or Unit Number ___________________________________________________
City________________________ State________ Zip Code_____________
Phone___________________________________
Cell Phone_______________________________
Email Primary_____________________________@___________________
Email Secondary___________________________@___________________
Is it "okay" to share your email address with DVAPT members? Yes ________ No __________
*We promise not to sell or share your information with anyone outside of DVAPT
What is your preferred method of contact? _____________________________________________________________
As a chapter member, you will also become an “Affiliate Member” of APTi
DVAPT membership fee: $45.00** Please enclose a check payable to “DVAPT” and mail to:
DVAPT
704 Buck Lane
Haverford, PA 19041
**If you already belong to APTi, you may add chapter membership by sending
documentation and a check for $30 payable to “DVAPT”. Please also respond
to the following:
I joined APT International for the membership year through (date) _____________.
I joined as a:
“Professional Member” (paid $110 to APTi)
“Retired Member” (paid $75 to APTi)
“Student Member” (paid $55 to APTi)
Are you a NEW DVAPT member______ or a Renewing DVAPT member _____?
How did you hear about DVAPT? ____________________________________________________________________
Are you qualified / certified to administer the MBTI? _____________________________________________________
If you are not currently qualified / certified - do you plan to become qualified or certified? _______________________
What is your profession? ___________________________________________________________________________
Are you currently a student? ________________________________________________________________________
Are you currently "in transition?" _____________________________________________________________________
Content copyright 2012-2023. DVAPT. All rights reserved.
