Interested in joining the TLCCA?  Here's an application - press the Print button on your browser to print it out.
MEMBERSHIP APPLICATION - (NEW MEMBERS ONLY)
TEXAS LICENSED CHILD CARE ASSOCIATION
313 Harwood Road, Suite 100, Bedford, TX  76021
 
(   ) FULL MEMBER  
For Licensed Center Owners or Directors, you are entitled to all benefits and voting privileges.		 $110.00
(   ) ASSOCIATE MEMBER  
For Licensed Center Director or Staff member, if your company has at least one Full Membership in TLCCA.		 $ 60.00
Name________________________________________   Center Name_______________________________ 

Full Business Address_____________________________________________________________________ 

Business Phone #( ______ ) ____________________   Home Phone ( ______ ) _________________________ 

E-Mail Address ______________________________  Fax # ( _____ ) _________________________________ 

Licensed Capacity  ___________  Ages Served _______________    For Profit_________  Non-Profit_________ 

Urban _______   Suburban _________  Rural _________       #Full-Time Staff_________  #Part time___________ 

Accreditation:  NECPA ________ NAEYC ________ Other_______________ Date of Accreditation___________ 

Experience: _______________________________________________________________________________ 

Education:    Highest level of formal education attained______________________________________________ 

      Major field of study of Degree(s)___________________________________________________ 

      CCP Credential ___________________ CDA Credential_______________ 
       

    (    )  Check #_________________ Amount $_____________Make check payable to TLCCA 
    (    )  Visa  
    (   ) MasterCard #__________________________ Exp. Date_________ Amt. $_____________ 
      * If paying by credit card, you may FAX your registration form to 817-788-9428.  
       
    Signature__________________________________________________________________________ 
        By signing above, this authorizes TLCCA to charge my account.  
         
    Mail Application, Dues and Registration Form to the above address.
    Contribution or gifts to the Texas Licensed Child Care Association are not tax deductible as charitable contributions for income tax purposes.  However, they may be tax deductible as ordinary and necessary business expenses subject to restrictions imposed as a result of association lobbying activities.  The Texas Licensed Child Care Association extimates that 76% of your dues are deductible.