RETURN TO MEMBERSHIP TAB

LASACT MEMBERSHIP NEW/RENEWAL
DIGITAL FORM

Membership Year: 2024

Submission of this DIGITAL form indicates a clear understanding that international certificates will be processed as appropriate upon receipt of these forms. It also indicates an understanding that LASACT membership assures eligibility for the IC&RC International Certificate for applicants with an LAC, CAC, RAC, LPP, CPP, RPP, AADC, CCS, CCJP, CCDP, CCDP-D, or PRSS. LASACT membership renewal fee is $90. Total for reinstatement of membership status after March 31, 2024 is $115.

If you fall into any of the below categories, be sure to review the following:
-
Louisiana Addiction Counselor Training (LACT) Program students — membership MUST be kept current in order to continue to receive the discounted tuition rate. Failure to do so will result in loss of student member status.
- SAP’s qualified through testing with LASACT — you MUST keep your membership current in order to keep your SAP current and maintain your listing in our records.

Each field has a suggested answer, please consider the suggested answer. Every field MUST be filled out in order to submit!

APPLICANT INFORMATION

GENERAL INFORMATION

LAC, CAC, RAC, CIT, LPP, CPP, RPP, PSIT, CCS, CCGC, ATA
AADC, CCJP, CCDP, CCDP-D, PRSS, LPC, LMFT, LCSW, LMSW, SAP, OTHER

PAYMENT INFORMATION

3.9% Credit Card Convenience Fee will apply to all membership application payments. Card will be charged within 2-3 business days from submission date.
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