North Carolina Counseling Association: Join NCCA

New Member: Yes (check only if new membership)

Personal Information

Work Information

Do NOT include my name in NC Counselor directory.

Send a paper newsletter INSTEAD of email one.

Annual NCCA Membership Dues

$60.00 Professional, State, Associate

$15.00 Student (6 credit hours or more)
Students must submit their information by mail or fax to include their professor's statement.

$15.00 Emeritus

Annual NCCA Division Dues

NOTE: NCCA Dues are REQUIRED
for enrollment in any division.

APCSNC Interest Group — $10.00
NCGSA Interest Group — $5.00
NCACES — $10.00
NCCDA — $10.00
NCAHEAD — $5.00
NCAAC — $2.00
NCECA — $2.00
NCAMCD — $4.00
NCASERVIC — $3.00
NCASGW — $5.00
NCAOCA — $12.00
NCMHCA — $15.00
NCCCA — $10.00
AGLBIC of NC — $3.00
NCAMFC — $5.00
NCAADA — $5.00

Payment

Please fill in the credit card information below, or send a check by mail.

NOTE: NCCA Dues are REQUIRED
for enrollment in any division.

Professional dues may or may not be deductible in full or in part. Please check with your tax preparer. Approximately 10% of your NCCA dues are allocable to nondeductible lobbying efforts on behalf of the counseling profession in the state. Note: Graduate students must get approval from their major subject-field professor; contact NCCA for more information.

Check All That Apply

American Counselor Association
American School Counselor Association
North Carolina Licensed Professional Counselor (LPC)
National Certified Counselor (NCC)

Other licenses or certificates:

Credit Card Information

Please enter Cardholder's name and address if different from applicant's address above.

I am aware that I may be dropped from membership in the association for conduct that is contrary to or destructive of its mission according to its Bylaws and the Code of ethics of the American Counseling Association.
Please enter your initials*

Please check that all of the above information is correct. By clicking the "Submit Form" button I certify that the above information is correct.

Questions? Call the office at 919-256-2521 or toll free
at 888-308-NCCA(6222).

Click the Verify button to verify your registration data to check your entries and then optionally send the registration to NCCA, or Print it for FAX or Postal Mail delivery.

NCCA Membership 2007-8
P.O. Box 20875
Raleigh, NC 27619

or
NCCA Membership 2007-8
3901 Barrett Drive, Suite 202
Raleigh, NC 27609