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Individual Colleague Membership Application

Individual Colleague Membership Application2025-10-10T14:29:23-04:00

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Thank you for your interest in joining GCEA! Please note, our fiscal year/membership year runs July - June, therefore, we have two individual colleague membership cycles: Once approved, if you join between July 1-December 31, registration is $100; between January 1-June 30, registration is a prorated to $50.

Name*

Email*

What are your credentials (e.g. MS, CGC, PhD, MD)*?*

*Please note that we are not currently accepting student members.

Are you affiliated with a genetic counseling training program currently?*

Yes

No

With which genetic counseling training program(s) do you have an affiliation?

Program Director's Name*

Program Director's Email*

In what capacity are you affiliated (select all that apply):

Program leadership (Program director, Assistant director, Research advisor, etc.)**

Course director for one or more courses

Clinical supervisor

Guest lecturer

Program coordinator/manager

Thesis/capstone committee chair/member

Other

**only apply for individual membership if you are not included in your Program’s full membership

Other (Please Specify)

What is your reason for your interest in joining GCEA?

How are you involved in genetic counseling student education?

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