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Complete the following form to have a representative contact you and discuss your needs. *= Required Field

Parent / Guardian
*First Name:
*Last Name:
*Email Address:
*Home Phone:	( )
Daytime Phone:	( )
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Teen
Teen First Name:
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*Teen Gender:
*Teen Age:
Please give us a brief description of your teen

Notice:

tpsrep.com recommends adolescent services including schools, programs, treatment alternatives, therapists, and transport services; tpsrep.com does not own, control, manage, nor direct any individuals or companies that provide these services. tpsrep.com do not assume any liability or responsibility, implied or otherwise for said services, we are neither Doctors nor trained professionals, we merely provide recommendations for services. Therefore, all liability or responsibility for any recommended services is assumed entirely by the service provider, as outlined in their individual enrollment agreements with the parent/sponsors.

Although tpsrep.com, Inc. Recommends a variety of programs and schools for which it receives no compensation, tpsrep.com, Inc. Receives advertising revenue and referral fees from some schools, including Tipton Academy. Tipton Academy has a close association with tpsrep.com, Inc., and tpsrep.com, Inc. will generally recommend Tipton Academy or other revenue producing schools if they meet the client's needs, and they are appropriate for the situation of the child being referred for enrollment.