Please complete the application and the Agency Status Survey. Your agency will be invoiced for software and accreditation fees and sent an agreement. Please contact your Program Manager for additional information at 1-800-558-0218.

Agency name (as it should appear on your accreditation certificate)

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* Agency name (as it should appear on your accreditation certificate)

What services does your agency provide?

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* What services does your agency provide?

Mailing address

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* Mailing address

Physical address (if different from above)

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* Physical address (if different from above)

County

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* County

Phone number

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* Phone number

Chief Executive Officer

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* Chief Executive Officer

CEO email address

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* CEO email address

Accreditation Manager

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* Accreditation Manager

AM email address

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* AM email address

Phone number

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* Phone number

Agency/Facility website

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* Agency/Facility website

Number of authorized pretrial services program employees

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* Number of authorized pretrial services program employees

Number of authorized probation services program employees

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* Number of authorized probation services program employees

Service area total population

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* Service area total population

How is your service area determined?

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* How is your service area determined?

Is your agency currently accredited by other organizations?

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* Is your agency currently accredited by other organizations?

If yes to Question 14, please indicate accreditation below

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* If yes to Question 14, please indicate accreditation below

Does your agency have a current copy of the FCAC Pretrial and Probation Standards Manual?

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* Does your agency have a current copy of the FCAC Pretrial and Probation Standards Manual?

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