First name
Last name
Email
Phone
Address
Membership Category Please select the category that best describes you:
Survivor Member (individual with lived experience of human trafficking or exploitation)
Supporter Member (community member, professional, advocate, or ally who supports the mission of the Coalition)
Lived Experience For Survivor Members, which best describes your experience?
Sex trafficking survivor
Labor trafficking survivor
Survivor of both sex and labor trafficking
Not a survivor, but a supporter
Professional Role For Supporter Members, please indicate your field or role:
Law Enforcement
Prosecutor
Attorney
Healthcare
Mental Health Professional
Social Services
Education
Faith Community
Parent or Family Member
Community Advocate
Business Professional
Other
Please share your skills and areas of interst to support the coalition
Please share any community or volunteer opportunities that you have done
Commitment to Collaboration and Survivor Leadership Members of the Arizona Human Trafficking Survivor Coalition agree to uphold the mission and values of the Coalition with respect and confidentiality
I Agree
*Membership Review Process Submission of an application does not guarantee membership. Applicants will participate in an interview with Coalition leadership. Membership decisions are made at the discretion of the Coalition
I Agree
Please note that a background check may be required at the cost of the applicant
I Agree
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