Membership Application

Membership Fee Levels:

  • Practitioner – $25 (Active PRAL members pay $15. Retired professionals pay $10.)
  • Student – $10 (Must be currently enrolled.)
  • Business/Organization – $50

Membership Type (required):
Choose one from the drop-down menu below:

General Member Information:

Full Name (required)

Phone (required)

Email (required)

Address (required)

Postal Code (required)

City (required)

State (required)

Practitioner Information:

Company/Employer (required)

Title (required)

Number of Years Employed (required)

Industry (required)

Responsibilities (required)

Student Information:

College/University Name (required)

Degree (required)

Graduation Date (required)

Application Submission & Payment

Click button below to submit application and pay with PayPal. To pay with PayPal, you will be taken to a separate PayPal Checkout page where you must add the fee for your Membership Type. If you do not wish to pay with PayPal, simply click the back button on your Web browser. Your application will still be submitted.

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