OHABA Membership Application
Please take a minute to fill out the form below to tell us a little bit about yourself. After you select your membership level, please remember to head to
to complete your membership payment.
Please Double Check your email
I did and it is correct!
Region of OHIO or Other States
Please select the general region of Ohio or Other State where you work.
Are you currently a BCBA?
If yes, please provide your BCBA number
Are you currently a BCaBA?
If yes, please provide your BCaBA number
Are you currently a COBA?
If yes, please provide your COBA number
Other organizations that you belong to
Area of Work
Social Work/ Counseling
Full Member: An individual is eligible to be a Full Member of OHABA if they are a member of ABAI, are certified by the Behavior Analysis Certification Board (BACB), or are certified by the state of Ohio as a behavior analyst (e.g. COBA). Affiliate Member: An individual who does not meet the criteria for Full and/or Student member status. Student Member: An individual classified as a student in a program of study leading to a degree in Behavior Analysis or a related discipline, and/or enrolled in a BACB-approved program to meet course requirements for BACB certification. Verification of student status must be provided by an administrator or faculty member of the program in which the student is enrolled (include with this application).
Page 1 of 1
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service