There are two categories of membership available to
colleagues wishing to be join ICADTS: Members and Affiliates. Members must
possess a demonstrated record of significant accomplishments in any of the
relevant disciplines that encompass the field of alcohol, drugs and traffic
safety, including program management as well as research. Affiliates include
those who have an interest in the field of alcohol, drugs and traffic safety
and ICADTS. Affiliates of ICADTS enjoy the privileges of membership, other than
voting and participation in its governance.
Affiliate Member Category
Applicants who wish to become ICADTS Affiliate Members should:
- Complete the top portion of this form and e-mail, fax, or mail it,
together with an electronic version of a curriculum vitae to the ICADTS
secretary. If possible, please use e-mail and
attach your cv to the e-mail. If e-mail is not available then mail
or fax the form with a cv that does not exceed 2
pages in length to the ICADTS secretary.
- Additionally the applicant should e-mail or mail this completed form
to one sponsor, who is a current members of ICADTS, along with a
copy of your cv. The sponsor will attest to the correctness of the
information provided. The sponsor can either:
- endorse the application
and return it to the ICADTS Secretary via e-mail, fax or mail or
- simply e-mail the ICADTS secretary stating that the sponsor has reviewed the
application, the applicant's cv, and that the sponsor is willing to endorse the
applicant for ICADTS affiliate membership. Please
use e-mail if possible.
| Name:
| ___________________________________________
| | Job Title: | ___________________________________________
| | Institute or Company: | ___________________________________________
| | Address: | ___________________________________________
|
| ___________________________________________
|
| ___________________________________________
| | E-mail: | ___________________________________________
| | Telephone: | ___________________________________________
| | Fax: | ___________________________________________
| | Signature of Applicant: | ___________________________________________
| | (not required for e-mail) |
| | Date: | ___________________________________________
|
This portion of the form to be completed by the sponsor
I have reviewed this application form and attachments, attest to the
correctness of the information provided and endorse the applicant for
affiliate membership in ICADTS.
| Applicant's Name:
| _____________________________________
| | ICADTS Member's Name: | _____________________________________
| | ICADTS Member's Signature: | _____________________________________
| | (not required for e-mail) |
| | Date: | _____________________________________
|
The sponsor can confirm their sponsorship by e-mail to the ICADTS Secretary.
Please return to:
Jean Thatcher Shope, MSPH, PhD
ICADTS Secretary
Research Professor and Associate Director,
Transportation Research Institute Research Professor,
Health Behavior & Health Education,
School of Public Health Director,
Center for Injury Prevention among Youth University of Michigan
2901 Baxter Road, Ann Arbor, MI 48109-2150
| 
