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NYS ATSA Membership Form
Please fill out the form below to finalize NYS ATSA Membership
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Email
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Your email
Name
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Professional Credentials (If applicable)
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Business or Mailing Address
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NY Region
Hudson Valley
NYC
Long Island
Capital Region
Western New York
Finger Lakes
Central New York
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Phone number
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Identified Discipline
Outpatient Treatment - Adults
Community Supervision
Inpatient Treatment - Adults
Research/ Academia
Attorney/ Judge
SOTP Administrator
Victim/Survivor Advocate
Assessment and Evaluation
Inpatient Treatment - Juveniles
Outpatient Treatment - Juveniles
Other:
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