Membership Interest Form

Membership Interest Form

Please complete this form to express your interest in learning more about the Assessment Practice Research Network (APRN), including membership and other opportunities to support the APRN's mission.
Name*

First NameLast Name
Email*
[email protected]
Professional Affiliation *
Location*
(e.g., State, Province)
Please estimate your current level of involvement in each of the following activities.
How much time is spent on doing clinical practice? *
Are you currently seeing clients specifically for assessment?*

YesNo
Are you currently seeing clients specifically for therapy?*

YesNo
How much time is spent on doing research? *
How much time is spent on teaching? *
How much time is spent on supervising? *
How much time is spent on administrative duties? *
What interests you about participating in the APRN? *
Should be Empty:

Please estimate your current level of involvement in each of the following activities.