GENERAL MEMBERSHIP

This membership entitles you to:

• Collaboration, comradery, and networking with California SAFE Teams and leaders
• Consultation, problem-solving, and technical assistance from experienced teams
• Updated educational resources based on science and evidence-based protocols
• Latest information about state and federal policies affecting SAFE Teams
• Pathway to legislative education on issues that affect SAFE practice and ideas for annual submission to California legislature
• Access to the members-only portal
• Weekly peer review and consultation zoom
• Sample protocols
• Position statements
• Job postings and members-only blog
• SAFE team directories in California

Terms:

$100 / Year

First Name:* First Name Required

Last Name:* Last Name Required

Phone:* Phone is Required

Street Address:* Street Address is Required

City:* City is Required

State:* State is Required

Zip Code:* Zip Code is Required

County Where Exams Performed:* County Where Exams Performed is Required

AlamedaAlpineAmadorButteCalaverasColusaContra CostaDel NorteEl DoradoFresnoGlennHumboldtImperialInyoKernKingsLakeLassenLos AngelesMaderaMarinMariposaMendocinoMercedModocMonoMontereyNapaNevadaOrangePlacerPlumasRiversideSacramentoSan BenitoSan BernardinoSan DiegoSan FranciscoSan JoaquinSan Luis ObispoSan MateoSanta BarbaraSanta ClaraSanta CruzShastaSierraSiskiyouSolanoSonomaStanislausSutterTehamaTrinityTulareTuolumneVenturaYoloYubaOther (Fill in Below)

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Your Title:* Your Title is Required

Make a selectionRNNPPAMD

Professional License Number:* Professional License Number is Required

Expiration Date:* Expiration Date is Required

Are you an examiner currently active with a sexual assault forensic exam (SAFE/SANE) team?:* Are you an examiner currently active with a sexual assault forensic exam (SAFE/SANE) team? is Required

Yes No In Process

Name of Exam Team or Hospital:* Name of Exam Team or Hospital is Required

Exam Team Coordinator or Director:* Exam Team Coordinator or Director is Required

Coordinator or Director's Email Address:* Coordinator or Director's Email Address is Required

Coordinator or Director Phone:* Coordinator or Director Phone is Required

How Long Have You Been An Examiner:* How Long Have You Been An Examiner is Required

Less Than 1 Year1 to 5 Years5 or More Years

How Many Exams Have You Completed (Approximately):* How Many Exams Have You Completed (Approximately) is Required

Less Than 1010 to 100100 or More

Team Name (If purchased): Team Name (If purchased) is not valid

Your Gender:* Your Gender is Required

Make a selectionMaleFemaleTransgender FemaleTransgender MaleGender non-conforming/non-binaryDecline to stateOther (Fill in Below)

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Your Race/Ethnicity:* Your Race/Ethnicity is Required

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Email:* Invalid Email

Password:* Invalid Password

Password Confirmation:* Password Confirmation Doesn't Match

Description	Amount
General Membership – Initial Payment	$100.00
Total	$100.00

Credit Cards

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