Application form student membership

We are very pleased that you would like to join the Dutch Association of Psychologists (Nederlands Instituut van Psychologen, NIP). With this membership you will enjoy several benefits at a reduced rate: only € 25,-. Please fill in your details below and we will process your request as soon as possible.

a. Personal information

Gender*

Initial(s)*

First name*

Prefix

Surname*

Date of birth*

b. Address information

Street*

House number*

House number suffix

Zip code*

Town/City*

Country of residence*

Mobile phone number*

Email address*

E-mail address (validation)*

c. Membership information

Membership starting date*

IBAN number*

Payment by direct debit*

Yes, I agree to pay the membership fee by direct debit

d. Study details

University*

Study programme title*

Specialization

Expected date of graduation*

Proof of enrollment as a psychology student or as a student of the master Mental Health*

- Photo or scan of the official proof of enrollment*
- Photo or scan of your student card stating 'student psychology'
- Print screen of your Studielink page

For students of the Open University:
- Photo or scan of the course registration

e. Choice of division

You’re automatically subscribed to the student division of the NIP (SPS-NIP). Additionally, it’s possible to sign up for two more divisions for free (with the exception of the division Neuropsychology).

First choice

Second choice

f. Statement of agreement

I hereby declare to have taken notice of the fact that the NIP membership runs and is paid per calendar year and that cancellation of the membership must be done in writing before the 15th of December of the calendar year previous to termination.*

Yes, I agree

I declare that I am currently following one of the undermentioned studies / courses:
* Bachelor's or Master's programme in Psychology
* Master's programme in Mental Health
* Master's programme in Orthopedagogy

Yes, I agree

I hereby declare that during my work as an upcoming psychologist (during internship) I will be guided by the Profesional Code of Ethics for Psychologists.*

Yes, I agree

I declare to have completed this form truthfully.*

Yes, I agree

Any questions and/or remarks

Student Membership

a. Personal information

b. Address information

c. Membership information

d. Study details

Proof of enrollment as a psychology student or as a student of the master Mental Health*

e. Choice of division

f. Statement of agreement

Follow us: