Apply - TACFS

Agency Name

Agency Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Main Phone Number

Agency Website

Executive Director/CEO Name

First Last

Executive Director/CEO Email

Alternate Contact Name

First Last

Alternate Contact Email

Is your organization accredited?

Yes
No

If yes, by whom?

Please list all other state and national affiliations.

Please indicate if your organization is a nonprofit or for-profit entity.

Nonprofit
For-profit

Please check the following license(s) your organization currently holds.

Child Placing Agency (Providing Foster Care Services)
Child Placing Agency (Providing Adoption/Maternity Services)
General Residential Operation (Providing Basic Child Care)
General Residential Operation (Providing Emergency Care Services)
Residential Treatment Center
Residential Treatment Center-IPTP (Providing Intensive Psychiatric Transition Program Services)
Supervised Independent Living (SIL)
Foster Family Group Home
Foster Group Home

Please list the Texas DFPS regions in which you provide services.

Please list the major programs your agency offers.

Please list the state agencies with which your organization contracts.

Department of Family and Protective Services (DFPS)
Juvenile Justice (TJJD)
Health and Human Services (HHS)
Education Agency (TEA)
Other (Please list below)

Other

Briefly describe your organization.

State your organization's mission statement.

Please attach your agency's logo for use in our Membership Directory.

Max. file size: 50 MB.

Please list your social media handles (Twitter, Facebook, etc.).

Dues Information

Membership dues are based on an agency's total annual budget for direct services to children and families in Texas and can range from $500 to $9500 annually.

New member agencies receive a half-price discount on the first year of membership dues.

Please provide the total agency budget for direct services to children and families in Texas for the last fiscal year.

Please provide the names of at least two references, preferably current Texas Alliance of Child and Family Services members, or other community partners, including contact information.

Document Uploads

Drop files here or

Max. file size: 50 MB.

Nonprofit Organizations: Please submit a copy of your IRS letter verifying your 501(c)3 status; all current licensure, accreditation or state operating requirements; and a copy of your last annual report, audit or operating budget.

For-Profit Organizations: Please submit a copy of all current licensure, accreditation or state operating requirements; and a copy of your last annual report, or operating budget.

You can also mail these to TACFS, 409 West 13th Street, Austin, Texas 78701; email to info@tacfs.org; or fax to (512)892-6977.

Signature

By signing this application for membership, you agree to support the TACFS Code of Ethics and Mission.

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