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NAPSEC Member Profile Update

Please include any information that needs to be added or changed on your program profile in the fields below.  You may leave fields blank if they do not require changes. Your previous information will be inserted into the blank fields. For members that have not yet filled out their profile sheet, please complete this entire form. 

Click on the above button to take you back to the NAPSEC Home Page and then go to the NAPSEC Directory site to see if you are in the NAPSEC Directory and if your listing is up-to-date.

Full name of program

Street Address

City/State/Zip

Phone

Fax

Web Site

Email for program

Contact email for NAPSEC

Director/President/
Principal of program

NAPSEC

contact name

Year founded

Date your program joined NAPSEC

Types of disabilities served
(Please do not use abbreviations)

Program description

 Program profile:

Enrollment
(check all that apply)

Male    Female    Coed

Age range served

Age at admission

I.Q. range served

Program
(check all that apply)

Day    Residential    Summer

Staff to client ratio

Program length
(in days)

Current enrollment

Total capacity

Admission procedures

Accreditation (NCASES, COA, JCAHO, etc)

Funding approval (State and/or

agency name)

Additional comments or clarifications

   

             

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