Apply for Membership
Thank you for your interest in joining the Academy! To apply for membership, complete the form below as thoroughly as possible. This form is confidential and will be sent over a secure connection.
Estimated time to complete: 45 minutes
Please note: This application must be completed in one sitting.
For assistance, contact our Enrollment Coordinator.
What you will need:
- Personal information
- Housing and transportation information
- Employment information
- Income information
- Medical information
- Provider information