A spreadsheet with your list of 40 programs and schools you visited in the past year. Please note that for membership renewals, the membership year is considered to be July 1 - June 30. Please use this period of time when answering the below Site Visit and Case Consultation Group questions.
- Each of the 40 visits should be unique, with no repeat visits during the membership year (July 1, 2023 - June 30, 2024). Up to 10% can be virtual visits. At least 1/2 must be therapeutic schools or programs. This can include local day schools or non-residential options in your own geographic area.
Any new relevant degrees or certifications
Any updates to your general information (email, website, etc.), business, and focus of practice

Unfortunately this form is not able to save incomplete applications.

Once you submit the form, you will be taken to a screen to pay your membership renewal fee.

Name *

First Name

Last Name

Preferred Name

Name of Business *

Business Street Address (if changed)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mailing Address (if changed)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Business Phone

(###)

###

####

Cell Phone *

(###)

###

####

Fax Number

(###)

###

####

Email *

Website *

http://

For Associate Members only, please indicate the month/year you started working actively with clients.

For Associate Members only, please indicate how many clients you worked with in a lead role in the past year.

Please List Any New Relevant Degrees or Certifications

Business Description (if anything has changed)

Dual Relationships - TCA Members may not be both referral professionals and employees or representatives of any program. If you have a relationship you are unsure about, please describe it here.

Please Rank Your Areas of Focus at Your Practice *

Number the following areas in order of importance to your practice:

Therapeutic
Substance Abuse
Non-Traditional Boarding School
Traditional Boarding School
Local Support Services
Intervention
Transportation
Non-Traditional Day School
Traditional Day School

Feel free to leave out any areas if they are not relevant to your focus.

Please Select the Age Groups You Work With *

Young Children (5 or younger)

Children (6-12)

Adolescents (13-17)

Young Adults (18-29)

Adults (30-64)

Seniors (65 or older)

Ethics Acknowledgement *

View Guidelines Here.

I acknowledge the TCA Guidelines of Professional and Ethical Best Practices. Breach of these guidelines may result in membership revocation.

Rights & Responsibilities *

View Rights & Responsibilities Here.

I acknowledge the TCA Rights, Responsibilities, and Benefits of Membership.

Active Engagement *

I will be actively engaged as a therapeutic, referring professional at least 1/3 of the time (15 clients for referral a year).

Request for Exception

I did not fulfill all of the requirements this year (July 1, 2023 - June 30, 2024), but I still want to be a valued TCA Member and will fulfill the expected requirements for next year.

Total Visit Verification

I verify I have completed 40 tours in the past membership year (July 1, 2023 - June 30, 2024).

Virtual Visit Verification

I verify no more than 10% of my visits were virtual visits in the past membership year (July 1, 2023 - June 30, 2024).

Therapeutic Visit Verification

I verify that at least 1/2 of my visits were with therapeutic schools or programs in the past membership year (July 1, 2023 - June 30, 2024).

Case Consultation Group Attendance *

TCA requires Professional Members to attend 4 of the monthly Case Consultation groups per year. Associate Members are required to attend at least 10 in a year. How many Case Consultation Groups did you attend this year (July 1, 2023 - June 30, 2024)?

Volunteer Opportunities: Share Your Interest Area(s)

The TCA is an all-volunteer organization focused on collaboration. We thrive with participation from our members. Please consider volunteering for a committee.

Please Select Your Membership Plan: *

Professional Member (Formerly Full Member): $400.00/Year

Associate Member: $400.00/Year

Emeritus Member: $100.00/Year

Thank you for your membership renewal!