Canadian College of Neuropsychopharmacology

CANADIAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY

COLLÈGE CANADIEN DE NEUROPSYCHOPHARMACOLOGIE

MEMBERSHIP APPLICATION

TYPE OF MEMBERSHIP (please check one): JUNIOR □ FELLOW □ AFFILIATE □ STATUS CHANGE □

Date:

CANDIDATE:

PRESENT POSITION: ______

CURRENT ADDRESS: ______

______

TEL. NO.: FAX. NO.: E-MAIL:

Summary of research interests:

______

Name & address of one sponsor (For Fellow applications, sponsor MUST be a CCNP member for at least one

year; Provisional junior members can sponsor another junior member application):

ACCOMPANYING THE APPLICATION SHOULD BE:

1. Nine (9) copies of this application form (Please collate into 9 identical sets to facilitate distribution to Committee members.)

2. Nine (9) copies of curriculum vitae, and

3. Nine (9) copies of three (3) reprints of applicant’s recent work in area of psychopharmacology

(Note: NOT required for applicants for Junior Membership.)

YOU CAN EITHER SUBMIT YOUR APPLICATION ON-LINE AT THE CCNP WEBSITE OR

MAIL TO: Ms. Rachelle Anderson

Administrative Assistant - CCNP

Department of Psychiatry University of Alberta

Edmonton, AB T6G 2B7

APPLICATIONS ARE CONSIDERED ON AN ONGOING BASIS. PROVISIONAL MEMBERSHIP STATUS MAY BE GRANTED UPON REVIEW OF THE APPLICATION AND THEN RATIFIED AT THE ANNUAL MEETING.

TYPES OF MEMBERSHIP

Fellows: This category of membership is reserved for those individuals holding an MD or PhD degree from a recognized university or showing evidence of equivalence in training or experience and who are presently engaged in significant scholarly activity (teaching and/or research) in the field of neuropsychopharmacology and/or psychopharmacology.

Affiliate: Any individual or institution willing to support and contribute to the activities of the College may be considered for affiliate membership. Individuals who are engaged in scholarly activities in the field, but whose prime interest is another area, may be considered for affiliate memberhsip. The Membership Committee, in consultation with the Finance Committee, is to review and make recommendations to Council for institutional memberships. The affiliate member shall have a voice, but not a vote and may not hold office.

Junior: Research trainees could maintain this status for up to five (5) years after completing a PhD, MD or equivalent, or until obtaining an appointment as Assistant Professor or equivalent. Such members will be charged a minimal annual fee and will not have a vote. They will pay a reduced registration fee for the annual meetings of the College.