Membership application form

Fill in this form to join PACT. Fields marked * are required. After you submit, please pay the membership fee into the PACT bank account shown at the end of this page.

A) Personal information

Name * S/o, D/o, W/o *

Date of birth * CNIC no. (passport no. if not in Pakistan) *

Contact no. * Email *

B) Qualification and work

Qualification * Affiliated institution * Department (if employee) Class (if student)

C) Address

Official address Residential address *

D) Membership category

Choose a membership category * Fee payment receipt (if you have already paid)

Declaration

I agree to abide by the Constitutional requirements and the Rules and Regulations of the Association. *

Pay the membership fee into
Bank name: Faysal Bank
Account number: 3484301000003027
IBAN: PK12FAYS3484301000003027
Account title: Professional Academy of Cognitive Therapy (Pvt.) Ltd.

After paying, email your receipt to pactorgmembership@gmail.com if you did not upload it above. Problems with the form? Email us at the same address.