2024 GLACLP Membership Application
Hello! Thank you for joining us for the 2024 GLACLP membership year. No matter if you are a returning member or a new member, we appreciate your support! 

You will complete your membership application and payment completely online. First, complete this google form. Once submitted, you’ll be provided a link to submit payment. Please plan to complete both the application and payment process within 30 minutes from start to finish to help avoid technical glitches. Please note that when you arrive at the payment screen, you are given PayPal and credit card payment options. You may pay via either of these platforms. You must complete both the application and payment steps for your membership to be considered complete and in good standing. You will receive automated emails and on-screen messages after completing the form and submitting payment so please watch your email and screen and read carefully. We suggest printing and/or retaining these messages for your records. Membership runs the calendar year and is valid until December 31 of each year, no matter when you join.

Please visit the GLACLP website at www.glaclp.com for the most up to date information regarding the organization. Don't forget to check us out and like us on Facebook and Instagram! Watch your email around the 15th of every month for our member only newsletter.
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Email *
First Name *
Last Name *
Membership Type *
What title do you have? Please select the one that best fits you. *
Are you certified through the Association of Child Life Professionals? *
Number of years as a CCLS (if applicable) *
Number of years since completion of internship (if applicable) *
Number of years working as a Child Life Assistant (if applicable) *
If you are a student, what year are you in school? *
If you are a student, have you completed a pre-internship experience? *
If you are a student, have you completed an internship? *
What type of organization do you work for as a fellow, CLA, or CCLS? *
What gender do you identify as? *
What pronouns do you prefer? *
Please specify your ethnicity. *
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