Annual COTAD Chapter Commitment Form
As a COTAD Chapter, we commit to:
1) Complete needs assessment survey provided.
2) Identify and mentor a future COTAD Liaison.
3) Commit to have at least one representative on quarterly program calls.
4) Share materials developed by your Chapter with COTAD.
5) Pay annual dues of $100. These dues help cover associated costs and will give you access to COTAD resources, support and mentorship from COTAD members. Dues to be paid via PayPal at cotad2015@gmail.com.
6) Submit an annual report to COTAD on your Chapter’s initiatives using the provided form.
7) Commit to complete 4 initiatives which can include but not limited to:
a. Community presentations about OT
b. Engaging with other departments in your University.
c. Hosting events to increase discussion or awareness within your OT student body.
d. Developing needed resources that your Chapter has identified.

Thank you so much for joining the COTAD Network! We look forward to working with you.
Email address *
University Name
Faculty mentor name and email
Primary COTAD Liaison and Email
Please identify four initiatives you intend to pursue: Some examples include: dialogue about unconscious bias ; Holiday toy drive ; Local school outreach ; Social Event to increase awareness about occupational therapy ; Panel Discussion
Confirm that both the student COTAD Chapter leader and faculty mentor agree to the requirements laid out above and are committed to complete the above initiatives for this Chapter.
Please enter the date of this agreement.
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A copy of your responses will be emailed to the address you provided.
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