Application for Affiliated Chapter Status

ABAI is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.

Please fill out the on-line form below.

In order for your chapter application to be processed, you must send the following information to ABAI:

• Signatures of 10 current ABAI members who support the formation of this chapter, all of whom must have at least a master’s degree and live in the area to be served by the chapter (if any signatory does not live in the area to be served, a justification must be made as to why that person should be included as a signatory)
• Bylaws for the chapter
• One copy of the chapter's most recent publication, if applicable

Name of Chapter

Contact Person Information

First Name

Last Name

Street Address

City

State

Postal Code

Country

Home Phone

Work Phone

Fax

E-mail Address

Type of Chapter:

Local State Regional National

Describe the geographic boundaries of the chapter, as well as what needs will be filled in the proposed geographic area by an ABAI-affiliated chapter.

List the name, office held, and ABAI membership status (verified by ABAI office staff against the ABAI membership database) of each of the chapter officers.

Chapter mission/objectives:

Description of membership:

Chapter journals and if printed, e-mailed, or posted on the web:

Describe the chapter's activities (meetings, workshops, publications, etc.). Include meeting dates and time of year of publications.

I will send the required information (listed above) to the ABAI office.

Yes No