• Child Life Program Membership Application

  • Please ensure that you have reviewed the Child Life Program Membership cost that matches the slots needed for your team. For questions and/or support, please email membership@childlife.org. 

     

    Click here to review the tiers and costs associated with ACLP Child Life Program memberships.

  • Child Life Program Information

  • Format: (000) 000-0000.

  • Internships

  • Does this program offer internships?*
  • Internship Requirements (please check all that apply)
  • Does this program follow the ACLP recommended application deadlines?
  • Does this program accept unaffiliated internship students?
  • Does this program require liability insurance for unaffiliated interns?
  • Does the internships require application materials in addition to the common application?
  • Does the internship application require official transcripts?
  • Does the internship require in-person interviews?

  • Practicums

  • Does this program offer practicums?*
  • Practicum Requirements (check all that apply)
  • Does this program accept unaffiliated practicum students?
  • Does this program require liability insurance for unaffiliated practicum students?
  • Does this program require liability insurance for unaffiliated practicum students?
  • Does the practicum application require official transcripts?
  • Does the practicum require in-person interviews?

  • Fellowship

  • Does this program offer fellowship?*

  • Volunteer Opportunities

  • Are there hospital wide volunteer opportunities at your hospital?*
  • Are there child life specific volunteer opportunities at your hospital?*

  • Hospital Profile

  • Areas Where Child Life Services Are Provided ON the Main Campus - check all that apply
  • Areas Where Child Life Services Are Provided OFF the Main Campus - check all that apply
  • Indicate which division the Child Life Department reports to:

  • Please indicate if/how the following complimentary programs are managed at your hospital.

  • Child Life Services

  • How do patients receive child life services?
  • Please select the areas where child life services are provided on the main campus.

  • Submitter's Information

  • Format: (000) 000-0000.

  • Child Life Program Leader (if different from submitter)

    The child life program leader
  • Format: (000) 000-0000.

  • Staff List

    Complete this section to add your team to your membership. An invoice will be sent once your application is processed.

  • Please add your staff list below. You MUST include first name, last name, email address, job title, and individual member type for each staff. If known, please include the ACLP ID numbers as this will expedite the processing of your membership. 

    Only the following membership types are allowed under a child life program: healthcare ally, professional, or associate. Please assign accordingly.

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