New Membership Application

Use the form below if you would like to become a NEW member of the BSC Biofeedback Society.

Current members Renew here.

Once you become a member, your name and professional information will be listed on the BSC Members page in this website. This list will be helpful in networking with other biofeedback professionals in California and to provide information about your credentials and practice specialties to prospective patients.

Your listing will appear on the BSC site once we have confirmed payment of your dues.  Please make sure you both submit the application and pay with PayPal or a check.

Email*
Password*
Password (again)*
First Name*
Last Name*
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Profession/Title
Business Name
Business Address
Business Address 2
Business City
Business Zip
Business State
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Business Phone
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Business Fax
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Degrees (Abbreviations Only)
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Website (example: mysite.com)
Bio


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