ATAC is a U.S.-based coalition of AIDS treatment activists, persons living with HIV/AIDS, and their allies. Because of the nature of our work, direct employees of drug companies and indirect employees of a drug company, i.e., individuals engaged in rendering services to a drug company through a contracted, for-profit business, including without limitation public relations firms are not eligible for membership.

Please read and complete all requested information. Incomplete applications will be returned or will be referred to the membership committee of the Board of Directors.

STEP 1: Please Select the Membership Type and Working Group Below:

* = Required fields

MEMBERSHIP / WORKING GROUP INFO:
ATAC now has two possible levels of membership to consider. Please read the explanations and select the option that best fits your desire.
Membership Type Applying for:	Full Membership Mailing List
What working groups are you applying for? (Please check all that apply)
Drug Development:
ADAP Access 360:
Immune-Based Therapies
None at this time:

*First Name *Last Name URL Email Address Street Address Unit/Suite *City *State   *Zip *Primary Phone Number Secondary Phone Number EXPERIENCE Please input information below regarding your work and experience with HIV, AIDS Activism, advocacy and related skills used within this area: Do you work (paid or volunteer) for any HIV related organization? Yes No Position Title Organization Are you employed by the pharmaceutical industry? Yes No If yes, please provide us with a description of your employment. Please write a short statement (one paragraph) describing your personal interest in AIDS activism and ATAC.