Your Name:

Your E-mail address:

Your Agency/Site Name:

City & State:

What type of agency/site do you work at? Select One Police Detention Diversion Probation Court Other

If "Other," please specify type of agency/site:

Total number of personnel at your agency/site:

What type of population do you serve? Select One Urban Suburban Rural

Briefly describe your interest in receiving the MASTLE (e.g., designing a police diversion process, we are considering adding it to an existing diversion process, conducting a research project, etc.):

Terms of Use Agreement for the Massachusetts Arrest Screening Tool for Law Enforcement (MASTLE)

I, Please Type Your Name: , agree not to modify the actual items of the Massachusetts Arrest Screening Tool for Law Enforcement (MASTLE)  without written permission of the authors. I understand the cut off scores for the total score can, and possibly should, be modified based on results in my jurisdiction.

I also agree not to disseminate the MASTLE, including postings to websites, as the MASTLE is copyrighted and should only be disseminated by the developers.

I also agree to provide a de-identified dataset of the MASTLE screening tool items and youth demographics if requested by the developers and if the required data-sharing agreements and protections are put in place. This is solely so the authors may use the data to  refine and norm this screening tool.

Your Signature: The parties hereby agree that either an electronic signature or your typed name in the space provided for "Your Signature" is an acceptable, signed authorization
that you agree to abide by the above Terms of Use Agreement.

Date: (mm/dd/yyyy)

THANK YOU FOR YOUR REQUEST!