Associate Registration

APPLICANT INFORMATION

First Name*

Last Name*

Pronouns*

HOME | Street Address *

HOME | City*

HOME | ST*

HOME | Zip Code*

Primary Phone*

Home Phone

Username*

E-mail Address*

Back-Up Email

Password*

Confirm Password*

Facebook

Twitter

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FOR ASSOCIATE LEVEL APPLICANTS

Outlet Name or School/Writing Program

Outlet Address

City

Zip Code

Work Phone

Url

Assigning Editor

Title

Editor Phone

Editor Email

Additional Outlet

Url

Additional Outlet

Url

BRIEF NARRATIVE RESUME

REASON FOR JOINING ATCA

Sponsoring ATCA Member (Optional)

Date*

Please send your complete application along with four content sample links published within the last calendar year. Samples can be written reviews, interviews or articles; or audio or video links.

Content Sample Links*

Only fill in if you are not human

Associate Registration

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