Membership Interest Form
Please complete this form to express your interest in learning more about the Assessment Practice Research Network (APRN), including membership and other opportunities to support the APRN's mission.
Name
*
First Name
Last Name
Email
*
example@example.com
Professional Affiliation
*
Please estimate your current level of involvement in each of the following activities.
How much time is spent on doing clinical practice?
*
Please Select
Less than 25% of my time
25% to 50% of my time
50% to 75% of my time
More than 75% of my time
How much time is spent on doing research?
*
Please Select
Less than 25% of my time
25% to 50% of my time
50% to 75% of my time
More than 75% of my time
How much time is spent on teaching?
*
Please Select
Less than 25% of my time
25% to 50% of my time
50% to 75% of my time
More than 75% of my time
How much time is spent on supervising?
*
Please Select
Less than 25% of my time
25% to 50% of my time
50% to 75% of my time
More than 75% of my time
How much time is spent on administrative duties?
*
Please Select
Less than 25% of my time
25% to 50% of my time
50% to 75% of my time
More than 75% of my time
What interests you about participating in the APRN?
*
Submit
Should be Empty: