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Program Registration


Answer fields may appear small but you can type as much as you wish.

Please do not use your ENTER key to move from line to line
please use your mouse or TAB ONLY.

Program/School Name
Physical Address
City, State & Zip

GPS Address (if different)
City, State & Zip

Tour Contact Name
Contact Title
Office Phone
Cell Phone
Email
Web
Length of time program/school requires for a thorough tour
Other programs/schools in general geographic vicinity
(do not have to be in the same state)
My program/school is in the following category (check all that apply)
Therapeutic Wilderness Boarding/Prep         I-20 Certified*
Therapeutic Boarding Eating Issues           RTC
Aftercare/Transitional           Christian           Military
Special Needs Boarding Male Only Female Only
JCAHO Accredited
Other Please specify

Logo upload:

Logo Link payment method:
(must pick one)
Credit Card   Check
Request Invoice

* You can enroll students from abroad and issue I-20 visas so the international student may enter the United States.



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