ATSA Membership Application

Thank you for your interest in becoming a member of The Association for the Treatment and Prevention of Sexual Abuse. The online membership application is below. If you prefer to complete the application offline or print and complete it by hand, please download the Word Document application.

Contact membership@atsa.com if you have questions about the application process. If you have not read them yet, please review the ATSA Membership Benefits and Requirements.

We look forward to welcoming you as a member of ATSA!


Dear Colleague:
 

The Association for the Treatment and Prevention of Sexual Abuse (ATSA) is a non-profit, interdisciplinary organization incorporated in 1984 to foster research, develop guidelines for practice, facilitate information exchange, further professional education, and provide for the advancement of professional standards and practices in the field of sexual offender evaluation and treatment. The organization currently has over twenty-eight hundred members from all fifty states, Canada, several territories, and other countries.

The benefits of ATSA membership include ATSA’s quarterly newsletter, The Forum, a subscription to ATSA’s official journal, Sexual Abuse, and involvement in ATSA’s electronic discussion group used for clinical consultation, questions/answers, and networking purposes. Further, ATSA members receive registration discounts for the Annual Research and Treatment Conference and ATSA Master Classes.

In addition, we encourage ATSA members to take part in any of the standing or ad hoc committees. ATSA membership ensures your participation in a growing international network of professionals who, like yourself, are dedicated to advancing knowledge and improving professional practice in the field of sexual abuse.

By joining ATSA, you automatically become eligible to join your local ATSA Chapter. As a member of an ATSA Chapter, you can participate in committees at the local level and interact with other professionals throughout your region.

If you have any questions about ATSA or our membership application process, please do not hesitate to email membership@atsa.com or call us at 503-643-1023.


ATSA has several membership classifications available, please read the descriptions of these membership levels and choose the appropriate category below.

MEMBER

ATSA Member: A person who provides clinical services to, or conducts research, prevention, or program management of, individuals who have engaged in or are at risk of sexual offending. No degree or hour requirements. Examples include: Psychologists, therapists, social workers, medical practitioners, academics, researchers, program administrators, and others with similar duties. 

CLINICAL MEMBER

ATSA Clinical Member: An enhanced membership category for those with at least a master’s degree who have (1) conducted 2,000 hours or more of direct clinical services (assessment, individual and/or group treatment) to individuals who have engaged in sexual offending behavior and (2) are dedicated to pursuing a certain amount of continuing education units (CEUs) annually. While not a form of certification, it officially documents one’s ongoing training hours and provides evidence for employers who require continuing education.  Additional nominal fees will apply in 2023 due to the administrative costs to verify CEU’s. 

ASSOCIATE MEMBER

ATSA Associate Member: A person who is currently working on a full-time basis for at least 40 hours per week either in a related area (such as the treatment of sexually abused children, adult victim/survivors of sexual abuse, or non-offending spouses) or in a non-clinical capacity such as the criminal justice system. Individuals involved in clinical practice, providing assessment and treatment services, and/or those individuals involved in conducting research related to sexually offending behavior, who qualify for other member categories, are not eligible for membership in the affiliate category. 
*Associate members do not receive the journal or the listserv

STUDENT MEMBER

ATSA Student Member: A person who is currently registered at least as a half-time student, enrolled in a program pursuing an advanced degree, or its equivalent, in an accredited college or university in pursuit of a career related to the study or treatment of sexually offending behavior.  Verification is required from the school in which the student is enrolled at least as a half-time student studying a curriculum designed for earning an advanced degree. An Early Career designation and dues discount is applied to current Student Members’ who are transitioning to other categories post-graduation for one year.

ATSA membership follows the calendar year from January to December. Dues are collected annually, are not pro-rated, and should be received in the ATSA office by January 31st each year.

[NOTICE] Please note that you have 30 minutes to complete this form before it times out.  

Total Amount
Account
Please enter a Username to create an account. If you already have an account please login before completing this form.
ATSA Application
Were you referred to ATSA by another member?
Enter the name of the member who referred you.
If the application is associated with an ATSA chapter conference, please select which one.

1. CONTACT INFORMATION
Enter your degree and/or license abbreviation, as you would like it to appear after your name in correspondence. (e.g., Ph.D., M.S.W., LPC)
   

Your primary email address will be visible to other ATSA Members in the member directory.


2. PROFESSIONAL INFORMATION
Include your organization or agency name


3. MAILING INFORMATION
Enter your mailing information below. Mailing information is kept private.

If analogous organizations and/or individuals involved in research endeavors request the ATSA mailing list, do you consent to have your name, mailing address and/or email included on that list?
 


4. LICENSE/CERTIFICATION INFORMATION
List all current licenses, certifications and/or registrations below, including the state or province abbreviation for each listing.
If your Board (or other regulatory body) has online verification, no action is required on your part. However, if verification for your license is not available online, you must request verification from your Board to be sent to ATSA.

Students: Upload your current university transcript or other student verification document here. Verification must confirm at least half-time student status, or current enrollment in a graduate or doctoral program.
If student status verification is included in the student reference letter, separate verification is not required.
Alternatively, email verification to membership@atsa.com or fax to (503) 643-5084.


5. EDUCATION INFORMATION
Enter your higher education information below, beginning with the most recent.




6. CRIMINAL/ETHICAL INFORMATION

Have you ever been charged with a felony?
 
* If you have been convicted of, or plead guilty to a felony or misdemeanor sex offense or other violent, felony crime against persons, you are not eligible for membership in ATSA.

If you answered yes to 6a, include an explanation below.
Upload documentation for 6a here.
Or email documentation to membership@atsa.com

Have you ever been accused, investigated, and/or involved in unprofessional or unethical conduct?
 

If you answered yes to 6b, include an explanation below.
Upload documentation for 6b here.
Or email documentation to membership@atsa.com

Have you ever been denied membership in or been terminated from a professional organization?
 

If you answered yes to 6c, include an explanation below.
Upload documentation for 6c here.
Or email documentation to membership@atsa.com


7. PROFESSIONAL EXPERIENCE
Enter a brief job description below.

Enter the total number of hours in research and/or direct assessment/treatment with sexual abusers during the employment dates indicated above. If applying for the Professional Member category, include hours spent directly managing sexual abusers.

Enter a brief job description below.

Enter the total number of hours in research and/or direct assessment/treatment with sexual abusers during the employment dates indicated above. If applying for the Professional Member category, include hours spent directly managing sexual abusers.

Enter a brief job description below.

Enter the total number of hours in research and/or direct assessment/treatment with sexual abusers during the employment dates indicated above. If applying for the Professional Member category, include hours spent directly managing sexual abusers.

Enter the sum of hours from the 3 employment positions above for the Grand Total.


8. REFERENCES

If you are licensed or certified, we must verify all current licenses, certifications, and/or registrations. If your Board offers online verification, we will obtain the verification and no further action is required on your part. However, if you Board does not offer online verification, you must provide verification from your Board to ATSA.

If you are not professionally licensed, you must submit one letter of reference from a supervisor or colleague who is familiar with your professional work and ethical qualifications.

Please list the information of either your licensing board or your reference provider below.



Below is a list of information the Membership Committee would like included in the reference letter. Please forward this list to your reference provider when requesting the reference letter, or refer them to the online reference form at www.atsa.com/Reference.

  1. How long have you known the applicant and in what capacity?
  2. Are you currently supervised or employed by the applicant?
  3. Observations of the applicant’s work with sexual offenders.
  4. Specific job duties performed by the applicant (including treatment philosophy, techniques).
  5. Positive contributions to the field of sexual violence.
  6. Does the applicant demonstrate ethical integrity in professional and personal behavior?
  7. To the best of your knowledge has the applicant ever been accused, investigated, and/or involved in unprofessional, illegal, or unethical conduct?
  8. In your opinion, is the applicant qualified by professional and ethical standards to be a member of ATSA?

If you are applying for Student membership, request a reference letter from your academic or field supervisor. Information contained in that letter should address the specifics of your work and interest in the sexual offender field.

If you already have your reference letter, you can upload reference documents below, email them to membership@atsa.com, or fax to (503) 643-5084.

Include below any notes you would like reviewed with your application.


ATSA MEMBERSHIP TERMS
  • I understand that The ATSA Board of Directors shall establish minimum requirements for membership.
  • I understand that The ATSA Board of Directors shall review applicants and may, in its sole discretion, approve or reject an applicant.
  • I understand that any false, inaccurate or misleading information, including omissions provided on this form may result in my membership being denied or revoked.
  • I agree to receive electronic mail from ATSA including: Member Update, The Forum and other notices.
  • I understand that if I am found responsible and/or sanctioned for an ethical violation, subject to disciplinary action by a professional licensing board, or am denied membership in or terminated from a professional organization, I must fax or email information pertaining to these events to ATSA within two weeks or I risk my membership being denied or revoked.
  • I agree to support the objectives of the Association and to read and abide by the provisions of the ATSA Practice Guidelines and Professional Code of Ethics.
  • By checking Yes below and submitting this form, I agree to the above terms and I attest that all of the information that I am providing is true, accurate and complete.
 
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Click on the 'Contribute' button above to submit your application to the ATSA Office. 


Before submitting your application, please check to ensure that all required fields are completed (indicated with an *), and that your uploads are still attached. If you submit the form and receive an error message that required fields have been left blank, the uploads may need to be re-attached before submitting. 

ATSA membership follows the calendar year from January to December. Dues are collected annually, are not pro-rated, and should be received in the ATSA office by January 31st each year.