Sam Houston Chapter of the Texas Association for Play Therapy :: SHAPT

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The mission of the Association for Play Therapy is to promote the value of play, play therapy, and credentialed play therapists.

If you would like to become a Member, complete and submit the form to the right.

Contact email
playtherapy@shapt.org

MEMBERSHIP APPLICATION

I would like to join SHAPT as a

Regular Member ($20)
Student Member ($15)

Complete Name / Degree /
License / Certification

Home Address

City

State/Zip

Home Phone / Fax

Work Phone

Organization Name

Address of Organization

E-mail Address
(All information from SHAPT will be sent
to this email address)

Location of Practice

Specialties

I am interested in becoming
involved in SHAPT

Leadership Position
Volunteer for Specific Events
Presenter
Committee Participation
Other

I would like to link my Private Practice
on www.shapt.org

Yes
No

If yes, the following information will be
listed on the website

Please list my email address above
Do not use the email listed above

If no, provide additional email address

Area of Town

If not listed, specify OTHER area

List up to three specialty areas
(such as LPC/RPT Supervisor,
Grief, Bi-lingual)

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