Psychosocial Rehabilitation/Réadaptation Psychosociale Canada (PSR/RPS Canada)
Promoting, supporting and strengthening community-oriented rehabilitation service
Promouvoir, soutenir et consolider des services de réadaptation axes sur la communauté
MEMBERSHIP APPLICATION
Class of Membership
Fee Structure
Fees based on organizational or program budget as follows:
including HST
CLASS: ORGANIZATIONAL MEMBERSHIP
PSR Canada service provider, advocacy and other
organizations interested in furthering the objectives of
PSR/RPS Canada. Benefits include:
 Full access to the PSR/RPS Canada and United States
Psychiatric Association (USPRA) websites
Budget less than $500,000
 $ 339.00
Budget of $500,000-$1,000,000
 $ 565.00
Budget greater than $1,000,000
 $1,130.00
3 Levels
 A subscription to the Psychiatric Rehabilitation Journal. Two
(2) copies.
Silver - $1,000.00
 A PSR/RPS Canada Newsletter
Gold - $2,000.00
 Discounts on PSR/RPS Canada, including chapters United
States Psychiatric Rehabilitation (USPRA) conferences and
training events
(Receive free advertising space in our
newsletter & recognition on PSR
website)
 An opportunity to serve on the PSR/RPS Canada Board and
committees
 Voting privileges on PSR/RPS Canada issues and elections
 An opportunity to contribute to the development of a
comprehensive international association in PSR
(recognition on our website)
 $2,260.00
 $3,390.00
Platinum - $3,000
(Receive free advertising space in our
newsletter, 1 extra journal and 1 free
registration for a person with lived
experience and recognition on our
website)
CLASS: INDIVIDUAL MEMBERSHIP
Fee Structure
Persons interested in furthering the objectives of PSR/RPS
Canada. Organizational Membership employees do not require
an Individual Membership due to their affiliation with the
organization. Benefits include:
Individual Membership
 $ 180.80
(with journal subscription)
 Full access to the PSR/RPS Canada and United States
Psychiatric Association (USPRA) websites
 A subscription to the Psychiatric Rehabilitation Journal
Individual Membership
 $ 90.40
(without journal subscription)
 A PSR/RPS Canada Newsletter
 Discounts on PSR/RPS Canada, including chapters & United
States Psychiatric Rehabilitation (USPRA) conferences and
training events
 An opportunity to serve on the PSR/RPS Canada Board and
committees
 Voting privileges on PSR/RPS Canada issues and elections
Associate Membership
 $ 33.90
(without journal subscription)
(Consumers, Family members, Students,
and/or other individuals with limited
income who support the mission of
PSR/RPS Canada)
 An opportunity to contribute to the development of a
comprehensive international association in PSR
CANADIAN JOURNAL OF COMMUNITY MENTAL HEALTH
Canadian Journal of Community Mental Health
Fee Structure
Individual Subscription
 $ 45.20
Organizational Subscription
 $ 145.60
HST # 8644805212 RT0001
Psychosocial Rehabilitation/Réadaptation Psychosociale Canada (PSR/RPS Canada)
Promoting, supporting and strengthening community-oriented rehabilitation service
Promouvoir, soutenir et consolider des services de réadaptation axes sur la communauté
MEMBERSHIP APPLICATION
Member Information: (Please print clearly and complete the information as requested):
I am a current Member: 
I am a new Member: 
Contact Information (for organizational/individual/associate):
First Name: ________________________________
Last Name: _______________________________
Position: _______________________________________________________________
Mailing Address:
_______________________________________________________
_______________________________________________________
Postal Code:
__________________________
Telephone:
(
Email: ________________________________
) ___________________
Fax #: (
) __________________
Organization/Agency (We require the organization name/key contact for organizational memberships)
________________________________________________________________________________________
Payment Method: (Please add HST to your order)
Amount:
 Cheque
 Money Order
 VISA
 Mastercard
Expiration Date:
Credit Card #:
Authorized Signature:
I give permission to PSR/RPS Canada to automatically renew my membership on April 1st each year on my credit
card. Signature: _______________________
Please return this form with full payment to:
PSR/RPS Canada
P.O. Box #13060
140 Holland Street West
Bradford, Ontario L3Z 2Y5
Phone: 1-866-655-8548
Fax:
(705) 456-9786
Email: support@psrrpscanada.ca
Membership Contact Use: (PLEASE COMPLETE)
Federal Privacy Legislation requires that individuals consent be provided in order to allow access to the PSR/RPS membership list.
I, __________________________________ give consent for PSR/RPS Canada and its affiliates to use my address in the following
situations: PSR/RPS Member request; Chapter correspondence; Mail-outs initiated by PSR/RPS Canada and/or its affiliates and
associated chapters.
Date Processed: ___________________
Cheque # or CC Auth # _____________
HST # 8644805212 RT0001