Application for Membership as a Developing Group

1. Name of Group

2. Address

3. Names of Members of Group (please attach brief resume of each member)

4. Statement of the Group's educational purpose with respect to the study of Analytical Psychology

5. Invitation to IAAP to send a representative on a "site visit" to interview members of the group and make a recommendation to the

Sub-Committee for Developing Groups
September 2004