EMDR HAP - Volunteer Registration

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Contact Information:
Mailing Address:
EMDR HAP
2911 Dixwell Avenue, Ste. 201
Hamden, CT 06518
Phone: (203) 288-4450
Fax: (203) 288-4060
Email EMDR HAP

Continuing Education Info:

working with Thai children after tsunami

Read about EMDR accomplishments.

Make a donation
to assist us in our Efforts.

Volunteer Registration and Information Form

When you fill out this form, you will create a volunteer account. (If you have already registered and have a username and password. Click HERE to go to the Volunteer Login Page to access your existing account.)
To register as a HAP volunteer, please fill out the form below, establish a username and password, complete the lines with asterisks (*), and save your work (click on "Save and Continue>>" or "Save and Exit>>" at the bottom of each page). In the future, you will be able to access and update your information by going directly to Login to Your Existing Account
Please note all the fields that have * are required.
Please note that in order for you to be considered as a TRN volunteer you must fill out all of the information tabs that have required fields marked by **
If you have questions about HAP Volunteer Registration, contact us

LOGIN INFORMATION

Username: *
no more than 8 letters and/or numbers
ex: mary1234, 22skidoo

Password: *

Confirm Password: *

CONTACT INFORMATION

Name:

Title: *
First: *
MI:
Last: *
Suffix:

Address 1: *

Address 2:

City: *
State: *
Zip: *
Country: *

Tel (Primary): *   ext

Tel (Secondary):   ext

Mobile Phone:

Fax:

Email *