Renews yearly
No expiration
Email*
First name*
Last name*
Address*
City*
Zip Code*
Country*
State*
What type of membership?*
Organization
Community Member
Other
Which best describes you? (you can choose more than one)*
Governmental Agency
Collaborative
Foundation
Association
Survivor Consultant
Law Enforcement
Crime Victim Services
Research/academic
Immigrant/refugee services
Interpreter/language services
Legal Services
Courts
Medical Professional
Mental Health Provider
Substance use disorder treatment
Child Advocacy Center
Community based service provider
Faith-based
Business
Community group or community member
How many representatives will you/your organization have?*
1 Representative
2 Representatives
Names of Representatives*
What committee selections are you interested in
Economic empowerment
Education
Policy Advocacy & Research
Survivor Services
Steering