Membership Application


Executive Director

 /Program Head

Street Address

NAPSEC Contact

at Program

Contact's Email Address

Program Web Address

Ownership of Applicant

Corporation, non-profit

Corporation, for-profit

Single Proprietorship



Name & Address of Owner, Partner or Corporation

List national/state agencies that approve/license program with dates of validation.
List national/state accreditations


How did you hear about NAPSEC?



Membership AZ/CA

Association Members






CA Alliance


Certification of Application


The undersigned hereby: Apply for membership.

Grant permission to public licensing agencies or any other relevant examining or reviewing agency or group to release official records and information concerning the named applicant to NAPSEC for its use, specifically with regard to consideration of this Membership Application.


Affirm that that agency is in compliance with all applicable local, state and federal laws and regulations required for private special education programs.


Agree that the named applicant, in order to maintain membership in NAPSEC, does publicly adhere to and practice the Code of Ethics of the Association. This document requires your signature. The document will be mailed with your membership materials once payment is received.






Please check here to affirm application information

provided is true and correct.





Please check appropriate dues payment box


Dues levels are based on your program's budget.

All first year members pay half price dues.


 Programs that have been members (non-renewals) within a three year time frame are not eligible for half price dues.


$600/$300.00             $0 - 750,000

$1,249/$624.50          $750,001 - $1,250,000

$1,722/$861.00          $1,250,001 - $3,000,000  

$2,217/$1108.50        $3,000,001 - $4,800,000

$2,701/$1,350.50       $4,800,001 and above


Voluntary dues are for members who wish to make an additional contribution to the association.


Sustaining/$2,801 Contributing/$3,135

Friend/3,592         Gold/$4,700       Platinum/$6,525



Pay By Check


Please check here if paying by check


Mail Payment To:

NAPSEC, 601 Pennsylvania Avenue, NW,

Suite 900 - South Building

Washington, DC 20004


Credit Card Payment  Visa       MasterCard      American Express
Credit Card Number
Expiration Date
Name on Card

Total Paid by

Credit Card



Watch for your membership materials in the mail!

Please make

a copy

for your files.


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