Human Rights Committee Interest Form
Name
*
First Name
Last Name
Email
*
example@example.com
Are you any of the following? (Select all that apply)
*
Licensed Health Care Professional
Attorney, Paralegal or Law Student
Psychologist or Master's Level Practitioner with expertise in Developmental Disabilities, Mental Illness, or Applied Behavioral Analysis
Individual receiving services, family member, or advocate
Why do you want to be on the Human Rights Committee?
*
What does "Human Rights" mean to you?
*
Submit
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