BSF MEMBERSHIP APPLICATION FORM

BSF MEMBERSHIP APPLICATION FORM

The Biofeedback Society of Florida (BSF) is a professional membership organization founded in 1978. BSF serves a diverse professional fraternity of health care providers and academicians who share an interest in applied psychophysiology, biofeedback, and neurofeedback. Member benefits include tuition discounts at APA approved CE workshops, a listing in the BSF provider directory, and collegial networking at BSF events.
To apply for BSF membership, please complete and submit this form with your dues payment.
Name*

First NameLast Name
Email address*
example@example.com
Enter a phone number where we can reach you*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please indicate your professional status. Check all that apply:*

Licensed PsychologistLicensed Clinical Counselor (LMHC)Licensed Clinical Social Worker (LCSW)Licensed Marriage and Family Counselor (LMFT)Medical DoctorAcademician (professor, researcher)Student (ID required)AAPB MemberOther - indicate below
Please enter your professional credential if applicable (PhD, PsyD, MS, MSW):
In a few words, please describe your professional interests and activities:*
I would like to be involved with BSF in the following ways (check all that apply):*

Board participationWorkshop planning/organizationHelp with publications and social mediaMembership developmentAttending workshops and other activitiesOther

Select credit card payment option:*

BSF one year FULL membershipAnnual BSF membership dues: January - December

$40.00

BSF one year ASSOCIATE membership (non-voting)Annual BSF Associate membership dues | January - December

$30.00

BSF one year STUDENT membership (student ID required - non-voting)Annual BSF Student membership | January - December

$20.00

Total

$0.00

My signature below authorizes BSF to charge my credit card for the above indicated charges.*

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Memberships begin on the date of your applicaton submission and continue through December 31.
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