IMGCA Membership Application

The International Mental Game Coaching Association welcomes individuals and organizations to apply for membership. IMGCA membership is open to anyone, in any country.

Please fill out the form below select your membership type and send us your contact information. Items marked * are required. Click "Submit" to submit the form, and then you will be taken to a page for making your payment via PayPal.

If you prefer to pay by check, print our offline application form and mail it to us with your check.

*	Please check this "verify" box so we'll know you're a real person.
*	Type of Membership: (prices listed are for annual membership)	Professional ($40) Volunteer ($40) Student ($10) Parent ($20) Institutional ($100) Affiliate ($60)
*	Your name:
*	Male   Female
	Date of birth:
*	Work street address:
*	Work City, state or province, zip:
*	Work phone:
*	Country:
*	E-mail address:
	Alternate email address:
	Home street address:
	Home City, state or province, zip:
	Country:
	Home phone:
	Academic status:
	Occupation:
	Research interests:
	Do you want to be included in the IMGCA member directory on the web site (available to members only)? Yes   No
	Text to follow name    in member directory:
	Note: This entry should be your area of specialty. If above item is blank, "Occupation" entry will be used in member directory.
	Comments or questions:
*	I have read and agree to the terms and conditions of IMGCA membership and to the terms and conditions of using the IMGCA web site.

Privacy notice: The information submitted on this application is used only for IMGCA purposes. At no time will we share any of this information with any other person or company.

Office Hours: Monday-Friday, 10am-6pm PST. Closed weekends and holidays.
Private backrooms in the IMGCA membership and certification areas are open 24-7, 365 days a year.

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