Apply for Membership

New member application

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.

Alternatively, you can download the PDF, print our new member application and return it to us by regular mail, confidential fax, or drop it off at one of our locations.

For assistance, contact our Enrollment Coordinator.

What you will need:

  • Personal information
  • Housing and transportation information
  • Employment information
  • Income information
  • Medical information
  • Provider information



New member application

Step 1 of 6: Personal information

Physical address

Mailing address (if different)

Family contact


If you answered yes to any of these questions, please indicate dates, causes and outcome below:

Membership goals

Referral source


You're invited!

Stop by and see what we're all about

We welcome you to come take a tour of the Academy. See the teams in action and enjoy a healthy lunch prepared onsite. To better accommodate you, appointments are preferred.

Schedule a tour Contact us
You're invited!

Sarasota Campus

1910 Glengary St.
Sarasota, FL 34231
(941) 921-9930

Bradenton Campus

601 12th Street West
Bradenton, FL 34205
(941) 929-2800

A network partner of:

Fountain House United

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The Academy at Glengary, Inc., is a 501(c)(3) charitable organization. All donations are tax-deductible to the extent allowed by law. The Academy at Glengary is registered with the state of Florida (CH56160). A copy of the official registration and financial information may be obtained from the Division of Consumer Services at or by calling toll-free 800-435-7352 within the state. Registration does not imply endorsement, approval, or recommendation by the state.

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