Member Profile Update Form for Website

Update Member Profile on Website

Please use this form to update your member profile as reflected on the current NAPSEC website. Thank you for your help!
Program/Organization Name
Program/Organization Website
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address for NAPSEC Website Listing (WILL be published)
example@example.com
Name of NAPSEC Primary Point of Contact (will NOT be published)

First NameLast Name
Email Address for Primary NAPSEC Point of Contact for member correspondence (will NOT be published)
example@example.com
Date founded
Population Served
Type of Program (select all that apply)
Total Student/Client Enrollment
Total Staff
Program Description (300 words or less)

0/0310
For-Profit/Nonprofit
Disabilities Served (select all that apply)
Ages Served
Program/Organization Logo

Cancelof
X
LinkedIn
Instagram
Facebook
Authorization and Code of Ethics Confirmation

I agree that the named program or organization publicly adheres to and continues to practice the Code of Ethics of the Association.
Please sign here to affirm the information provided is true and correct, and that you are authorized to update your membership profile with NAPSEC.
Name

First NameLast Name
Should be Empty:

Update Member Profile on Website