ATSA Student 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.

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
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ATSA Application
Were you referred to ATSA by another member?
Enter the name of the member who referred you.

1. CONTACT INFORMATION
   

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


2. PROFESSIONAL INFORMATION
Include your organization or agency name


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.



5. EDUCATION INFORMATION
Enter your higher education information below, beginning with the most recent.
Credit Card
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Billing Name and Address
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Terms of Membership
  • 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, which may include having my name published in the Forum newsletter in the event of an ethical sanction against me by the ATSA ethics committee.
  • I understand that if I am charged, convicted or plead guilty to a felony, I must notify ATSA within two weeks or I risk my membership being denied or revoked. I also 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 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 that I will not forward or share ATSA List Serve emails outside of subscribed ATSA membership.   Failure to abide by the ATSA List Serve Terms of Usage may result in removal from the List Serve and/or ATSA Membership.

By renewing my membership I agree to the above noted statements and affirm that all of the information 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.