Demographics

First Name *

Last Name *

Email *

Cell Phone *

Are you a current ATRA member? *

Yes

Are you representing an ATRA chapter? *

Yes

Specific Request

Which opportunity are you announcing? *

Research participation

General announcement

Conference announcement

Chapter announcement

Scholarship announcement

Grant funding announcement

Other

Other announcement not listed:

What is your relationship to the opportunity? *

Researcher involved

Primary investigator

Chapter representative

Conference organizer

Board member

Other

Other relationship not listed:

Information Dissemination

Do you have authority to announce this opportunity? *

Yes

How does your request fit ATRA's mission to empower recreational therapists? *

How would you like your information disseminated? *

Email blast

Facebook post

Instagram post

LinkedIn post

Twitter post

Post on ATRA website

Other

If other, please specify:

What is the purpose of your announcement (e.g, specific research project, specific event, etc)? If applicable, please include dates of your event. *

Conflict of Interest

A conflict of interest does not mean that ATRA will not post your opportunity. We want to do our due diligence to make sure that all requests meet ATRA code of ethics and the highest ethical standards.

Do you have a PERSONAL financial interest in the request? *

Yes

Maybe

Other

Specify:

Do you have a personal or professional relationship with anyone on the ATRA board or staff that could cause a potential conflict of interest? *

Yes

Maybe

Other

If other, please explain:

Comments you'd like to make regarding a real or perceived conflict of interest: *