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Personal Information
Tell us about you!
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Email
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Your email
First Name
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Last Name
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Your answer
Street Address
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Your answer
City
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Your answer
State
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Your answer
Zip Code
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Your answer
Phone Number Including Area Code (xxx) xxx-xxxx
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Your answer
Email for SWFL ABA to Use to Contact You
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What is your current role?
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Choose
ABA Professional (e.g., licensed psychologist and/or BCBA)
ABA Paraprofessional (e.g., RBT, ABA therapist, teacher assistant)
Related Professional (e.g., SLP, OT, Social Worker, Counselor, Teacher)
Family Member or other stakeholder (e.g., neighbor)
Are you a FABA Member?
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Yes
No
Maybe
Type of Membership
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Full Professional $25 (includes Licensed Psychologists and BACB Professionals)
Full Paraprofessional $15 (includes RBT but MUST be FABA member)
Limited Professional $25 (includes licensed professionals in other fields, e.g., SLP, OT, LPC)
Limited Paraprofessional $15 (includes RBTs who are NOT FABA members, direct care staff)
Family Member or Other Stakeholder (Free)
Are you interested in volunteering? Please let us know how you can help.
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Are you credentialed by the BACB? (e.g., RBT, BCBA, etc)
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Yes
No
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