Members

NYCPG Membership Application

Please fill out the form, print your completed form out then mail to:

NY Council on Problem Gambling
119 Washington Avenue
Albany, NY 12210

	$25 Individual Member - Full membership for any individual over 18 years of age.
	$100 Sponsor Contributor - Financial donation
	$500 Patron Contributor - Financial donation
	$1,000 Corporate Contributor - Financial donation

Name:
Agency Affiliation:
Title:
Address:
City:	State:Zip Code:
Telephone Number:	- -
FAX Number:	- -
Email Address:

Enclosed is a:	Check for $
	Money Order for $

Make all checks/money orders payable to:

NY Council on Problem Gambling
119 Washington Avenue
Albany, NY 12210
( All Donations are Tax Deductible )

The New York Council on Problem Gambling does not accept
donations, contributions, and/or grants of any kind from the gambling industry
operators or gambling equipment manufacturers.
Members will receive library privileges, discounts for specific trainings, and up-to-date problem gambling news and information.

The Association of Problem Gambling Professionals Membership

Mission:

The Association of Problem Gambling Professionals mission is to provide a forum where educational, prevention and treatment practitioners exchange experiences and ideas for providing quality services to those affected by problem gambling and to facilitate the expansion of knowledge in the field.

Who We Are:

The Association of Problem Gambling Professionals was created to provide an open forum to discuss educational, prevention and treatment issues related to the problem gambling field. The Association hosts educational and informative seminars as well as case study reviews.

When We Meet:

The Association of Problem Gambling Professionals meets on a quarterly basis in Albany, NY. Meeting time is 10 am - 2 pm. We will be meeting on:

¨ February 13, 2008

¨ May 14, 2008

¨ August 13, 2008

¨ November 12, 2008

Officers

President

James Maney

New York Council on Problem Gambling

Albany, NY

Vice President

Catherine Eade

Gambling Prevention Coordinator, CCCASA

Olean, NY

Treasurer

Jerry Stipe

Center for Problem Gambling, Family and Children's Service

Albany, NY

Secretary

Jacqueline Gibson

McPike Addictions Treatment Center

Utica, NY

THE ASSOCIATION OF PROBLEM GAMBLING PROFESSIONALS MEMBERSHIP REGISTRATION FORM

Please complete the form and mail it with your registration fee to:

Jerry Stipe

Center for Problem Gambling, Family and Children's Service

650 Warren Street

Albany, NY 12208

Name:

Address

Phone: FAX: E-Mail:

Membership Dues:

Yearly Membership: $50.00

Your membership dues include attendance at all 4 quarterly meetings for the year as well as lunch.

Individual Meeting Fee: $15.00

If you choose not to become a yearly member, you may attend any of the meetings for $15.00 each.

Please make checks payable to Family and Children's Service of the Capital Region and mail to Jerry Stipe, Treasurer at the above address.

For more information about the Association of Problem Gambling Professionals contact

James Maney at 518-427-1622 or email: jmaney@nyproblemgambling.org