Membership Application and Renewal for CACs

Membership Signup and Renewal

Name of Center*
Address*
Street Address Address Line 2 City ZIP Code
Your Name*
First Last
Title*
Phone (Work)*
Phone (Mobile)*
Fax
Phone (Emergency)*
Email*
Website*
Your CAC's Facebook page URL
Your CAC's Twitter handle
Briefly describe how your Child Advocacy Center meets the ten NCA Standards:
Multidisciplinary Team:*
Cultural Competency and Diversity:*
Forensic Interviews:*
Victim Support and Advocacy:*
Medical Evaluation:*
Mental Health:*
Case Review:*
Case Tracking:*
Organizational Capacity:*
Child-Focused Environment:*
Corollary Services:*
Ex: Body Safety Program, Stewards of Children
Strengths your CAC can bring to the Chapter:*
Number of forensics interviews provided in 2019:*
National Children’s Alliance (NCA) Membership Status:*
- Affiliate
- Associate/Development
- Accredited
- Non-Member
Agency*
Your Dues Total*
I would like to pay...*
- Online (includes processing fee)
- By check/mail
If paying by check/mail, an invoice with instructions for payment will be emailed to you after submitting this application.
Total Due
Price: $0.00
Total Due
Price: $0.00
Credit Card

Card Details

Cardholder Name
Electronic Signature*
By electronically signing and submitting this document, you are affirming your authority to submit this application on behalf of your Center and that everything stated herein is true and accurate to the best of your knowledge.
Date*
Date Format: MM slash DD slash YYYY

Our Vision

Indiana Chapter of National Children’s Alliance…ensuring that all children in Indiana alleged to be a victim of abuse will have reasonable access to a full array of evidence-based Child Advocacy Center services and an effective multidisciplinary response to their case and their care.

Our Mission

The Indiana Chapter is committed to promoting the development, growth and sustainability continuation of children’s advocacy centers in the State of Indiana through education, training, mentoring, collaboration, advocacy, development of resources and legislation.

NCA Standards

Accreditation standards set by the National Children’s Alliance are fully supported by the Indiana Chapter of the NCA and Indiana Child Advocacy Centers. We believe Hoosier children, families, and communities are better served and supported when we all reach for nationally recognized higher goals and standards with forensic interviewing, victim advocacy, and medical and mental health training.

INCACS

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Membership Signup and Renewal

Briefly describe how your Child Advocacy Center meets the ten NCA Standards: