Psychological Association of the Philippines
(The application period for first time applicants is from January 2 to February 28 of every year)
Name of applicant : (Please print in upper case/caps)
SURNAME/FAMILY NAME GIVEN NAME
Contact information (all information is required):
MIDDLE NAME
Permanent Residence: _________________________________________________________
Work Address: ________________________________________________________________
Phone/Fax: _________________________ Email address; ____________________________
Submission information :
Date submitted: ______________________
Checklist of application documents for Developmental Psychologist:
[ ] Cover Page of application form
[ ] Completed application form
[ ] Annex A: Transcript of records in relevant graduate degree
[ ] Annex B: Supporting documents for professional experience, if applicable
[ ] Annex C: Supporting documents for professional development activities
[ ] Annex D: NBI clearance or Certification from employer of no criminal record or sanctions
[ ] Two sets of all the documents above, placed in long folder with applicants printed name
(SANTOS, M. A.) on the ear of the folder. (pls. present documents in the listed order)
[ ] Two folders placed inside one big brown envelope with applicants printed name
(SANTOS, M.A.) printed on the upper right hand corner of the front side of the envelope, and the area of specialization applied for printed on the upper left hand side.
Printed Name and Signature of Applicant
To be filled up by PAP:
Payment made: [ ] Cash [ ] Check [ ] Others, please specify details: ____________
__________________________________
OR # _____________________________
Received by:
Submission Record #___________________
Printed name and signature
Updated 1-11-11
MRHechanova

Name of applicant : (Please print in upper case/caps)
SURNAME/FAMILY NAME GIVEN NAME
INSTRUCTIONS: Please fill up the form below.
For PAP Applicant’s Credentials use only:
[ ]
[ ]
MIDDLE NAME
1. Active Associate or Fellow of the PAP
Indicate current status:
_____ Associate
_____ Fellow
2. Educational Requirements:
2.a Educational Attainment.
Indicate Relevant degree earned:
A Master of Arts or PhD in psychology with major / specialization in:
_____ Developmental Psychology _____ Family Psychology
_____ Human Development _____ Behavioral Development
_____ Family Life and Child Development _____ Educational Psychology
_____ Counseling Psychology
_____ other (pls specify) ___________________
( Please submit original or authenticated transcript of records in Annex A)
[ ] 2.b. Coursework
Indicate which graduate courses taken:
_____ 3 units of an advanced level course in Developmental Psychology or Human Development
_____ 9 units of specialized courses on a specific period in the life span (i.e., infancy, child, adolescent, or adult development), and/or, a specific aspect of development (i.e., cognitive, social, emotional, behavioral, or physical)
_____ 6 units of Methods courses
_____ A thesis or culminating project on a topic in the area of Developmental Psychology
List graduate level courses taken:
Updated 1-11-11
MRHechanova

For PAP use only:
[ ]
Requirements Applicant’s Credentials
[ ]
[ ]
3. Developmental Psychology Experiences (for those who do not meet educational requirement)
Summarize relevant professional experience research, publication, and practice in areas that are pertinent to Developmental Psychology
(Please submit supporting documents: psychological reports, peer-evaluated research reports, reports and materials of consultancy projects, publications, and other outputs that fall within the various sub-areas of developmental psychology in Annex B)
4. Professional Development
Indicate total number of professional development activities in last three years
(Please submit supporting documents in Annex C)
5. Good Moral Character.
Evidence that you have not been convicted of any civil, criminal, or administrative offense, or of ethical violation related to the professional practice of psychology.
Indicate document submitted in Annex D.
_____ NBI clearance (for those not employed)
_____ Certification of Employer (for those employed)
*Please refer to the Primer on Certification of Psychology Specialist for other general and specific guidelines.
Printed Name and Signature of Applicant
Updated 1-11-11
MRHechanova