NAPSEC Member Profile Update

After entering the name of your program, 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. 

* Indicates required fields

* 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

Disabilities Served
(Please do not  abbreviate)

Program Description

PROGRAM PROFILE

 

Enrollment
 

Male    Female    Coed

Age range served

Age at admission

I.Q. range served

 

Program

Offered
 

Day    Residential    Summer

Staff to Client Ratio

 

Program Length
(in days)

 

Current Enrollment

        
 

Total Capacity

 

Total # Employed

 

 

Admission Procedures

 

Accreditation (NCASES, COA, JCAHO, etc)

 

Funding approval (State and/or agency name)

 

Additional comments

or clarifications

   

Thank you.

 

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