Please complete this Membership Application and submit it together with your payment. Applications received without payment, or payment received without a Membership Application cannot be processed. Questions? Email ISIPAR's Past President-Executive Director, Ronald P. Rohner at rohner.isipar@gmail.com.

* Required Field

Choose one of the following options:*

New Member
Renewal

Please provide the following contact information:

First Name *

Middle Name/Initial

Last Name *

Title/Postion

Organization

Highest Degree*

High School Diploma Undergraduate 2 yr. Undergraduate 4 yr. Master's PhD / MD / EdD / JD

Mailing Address *

Address (Continued)

City *

State/Province *

Zip/Postal Code *

Country *

Mobile Phone

Work Phone

Fax

Email Address *

 Gender:*

Male Female

What are your primary areas of interest?
(check all that apply)

Academic Issues	Corporal Punishment	Intimate Partner Acceptance-Rejection	Psychological and Behavioral Control
Acculturation/Immigration	Developmental Problems	Law Legal/Courts	Rejection Sensitivity
Affectionate Communication	Ethnicity	Lifespan Perspective	Resilience, and Coping with Rejection
Applied Research/Practice	Evolutionary Perspective	Methodological Issues	Sociocultural Correlates of Acceptance-Rejection
Attachment	Family Interaction (including parenting styles, marital relationships, etc.)	Ostracism/Social Exculsion	Substance Abuse
Biological Correlates of Perceived Acceptance-Rejection	Family Violence (other than child abuse & neglect)	Overview (summary of existing research)	Teacher Acceptance-Rejection
Bridging Theories	Father Love	Parenting Education
Child Abuse and Neglect	Gender/Gender Differences	Peer and Sibling Acceptance-Rejection
Clinical Practice	Normal Growth and Development	Psychological and Behavioral Adjustment and Maladjustment

Other Area(s) of Interest Not Listed Above:

From the table of dues information below and the countries represented within each of the economic categories, please select the membership type, annual dues rate, number of years, and World Bank economic category that applies to your membership.

 Membership Type:*

Full Member
Emeritus/Retiree
Student -Students applying for membership must verify their student status by submitting an endorsement from a faculty member (not necessarily an ISIPAR member).

Name of Faculty Member

University or College of Faculty Member

Email Address of Faculty Member

Annual Dues (Categories I through IV are based on the World Bank’s economic categories. See the listing noted below for the category to which you belong)

I. High Income Economies	1-year rate ($US)	2-year rate ($US)
Full Member	$45	$77
Emeritus/Retiree	$34	$58
Student*	$22	$37
II. Upper Middle Income Economies
Full Member	$35	$60
Emeritus/Retiree	$26	$44
Student*	$17	$29
III. Lower Middle Income Economies
Full Member	$25	$43
Emeritus/Retiree	$19	$32
Student*	$12	$20
IV. Low Income Economies
Full Member	$15	$23
Emeritus/Retiree	$11	$19
Student*	$7	$12
Countries represented within each of the economic categories (as of July 2009):
I. High-income economies (66)
Andorra	France	Netherlands Antilles
Antigua and Barbuda	French Polynesia	New Caledonia
Aruba	Germany	New Zealand
Australia	Greece	Northern Mariana Islands
Austria	Greenland	Norway
Bahamas, The	Guam	Oman
Bahrain	Hong Kong, China	Portugal
Barbados	Hungary	Puerto Rico
Belgium	Iceland	Qatar
Bermuda	Ireland	San Marino
Brunei Darussalam	Isle of Man	Saudi Arabia
Canada	Israel	Singapore
Cayman Islands	Italy	Slovak Republic
Channel Islands	Japan	Slovenia
Croatia	Korea, Rep.	Spain
Cyprus	Kuwait	Sweden
Czech Republic	Liechtenstein	Switzerland
Denmark	Luxembourg	Trinidad and Tobago
Equatorial Guinea	Macao, China	United Arab Emirates
Estonia	Malta	United Kingdom
Faeroe Islands	Monaco	United States
Finland	Netherlands	Virgin Islands (U.S.)
II. Upper-middle-income economies (46)
Algeria	Grenada	Peru
American Samoa	Jamaica	Poland
Argentina	Kazakhstan	Romania
Belarus	Latvia	Russian Federation
Bosnia and Herzegovina	Lebanon	Serbia
Botswana	Libya	Seychelles
Brazil	Lithuania	South Africa
Bulgaria	Macedonia, FYR	St. Kitts and Nevis
Chile	Malaysia	St. Lucia
Colombia	Mauritius	St. Vincent and the Grenadines
Costa Rica	Mayotte	Suriname
Cuba	Mexico	Turkey
Dominica	Montenegro	Uruguay
Dominican Republic	Namibia	Venezuela, RB
Fiji	Palau
Gabon	Panama
III. Lower-middle-income economies (55)
Albania	Honduras	Paraguay
Angola	India	Philippines
Armenia	Indonesia	Samoa
Azerbaijan	Iran, Islamic Rep.	Sao Tome and Principe
Belize	Iraq	Solomon Islands
Bhutan	Jordan	Sri Lanka
Bolivia	Kiribati	Sudan
Cameroon	Kosovo	Swaziland
Cape Verde	Lesotho	Syrian Arab Republic
China	Maldives	Thailand
Congo, Rep.	Marshall Islands	Timor-Leste
Cote d'Ivoire	Micronesia, Fed. Sts.	Tonga
Djibouti	Moldova	Tunisia
Ecuador	Mongolia	Turkmenistan
Egypt, Arab Rep.	Morocco	Ukraine
El Salvador	Nicaragua	Vanuatu
Georgia	Nigeria	West Bank and Gaza
Guatemala	Pakistan
Guyana	Papua New Guinea
IV. Low-income economies (43)
Afghanistan	Guinea-Bissau	Rwanda
Bangladesh	Haiti	Senegal
Benin	Kenya	Sierra Leone
Burkina Faso	Korea, Dem Rep.	Somalia
Burundi	Kyrgyz Republic	Tajikistan
Cambodia	Lao PDR	Tanzania
Central African Republic	Liberia	Togo
Chad	Madagascar	Uganda
Comoros	Malawi	Uzbekistan
Congo, Dem. Rep	Mali	Vietnam
Eritrea	Mauritania	Yemen, Rep.
Ethiopia	Mozambique	Zambia
Gambia, The	Myanmar	Zimbabwe
Ghana	Nepal
Guinea	Niger

Length of Membership:*

1 Year
2 Years

Annual Dues Rate in US Dollars (USD) (Enter Amount that applies to your membership from World Bank economic categories above)

Annual Dues $ USD*

World Bank Category:*

High Income
Upper Middle Income
Lower Middle Income
Low Income

Method of Payment:*

Check (make check payable in US Dollars to the International Society for Interpersonal Acceptance and
Rejection)

Return payment with the full name of the new or renewing member noted in the Memo line, to:
ISIPAR Central Office
c/o Ronald P. Rohner
University of Connecticut
Human Development and Family Studies, Room 208
348 Mansfield Road, U-2058
Storrs, CT 06269-2058 USA

PayPal (Go to www.PayPal.com or click the PayPay seal below to make your payment now)
Paypal payment goes to the Secretary-Treasurer, Parminder Parmar (prp104@psu.edu)

Western Union

Cash

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