2025 Membership Registration Posted on March 23, 2025 by James Besson Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu. RM_Stats Member Profile UpdateFirst Name *Last Name *Degree/License AbbreviationEmail * Profession and AgencyProfessional Area *Select an optionCommunity SupervisionEvaluationLegalManager/AdministratorTreatmentOther (Describe below)Profession description (If "Other" is selected)Agency Name * ListservPlease indicate below if you would like to be added to the WiATSA listserv. You will receive additional instructions, including the list guidelines, in a separate email.Add me to the listserv: Yes Membership TermsI am a current member of ATSA in good standing and will maintain my membership through the current year. I currently live, practice, or am licensed in the State of Wisconsin. I understand that if I am charged with a felony, am accused, investigated, and/or involved in unprofessional or unethical conduct, or am denied membership in or terminated from ATSA or any other professional organization, I must email information pertaining to the allegations and/or investigations to WI-ATSA within two weeks of the event, or I risk my membership being denied or revoked. 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.Agree to membership terms * Yes Date submitted *
