MP Confirm Partnership

Confirm Your Partnership for AY2025-2026

Should you need financial forms such as a W9 or ACH payment information, you can request these from our Financial Manager whose contact information will be on the invoice!

Use this form to CONFIRM your Managed Partnership with TCPS!

Partnership(Required)

Registration - this is our first year!

Renewal - Welcome back!

Today's Date:(Required)

School Name:(Required)

Program of Study/Major:(Required)

Program Level(Required)

Undergraduate

Graduate

Both

Campus or City:(Required)

Many schools will have multiple campuses so enter your campus location.

State:(Required)

Some schools have campuses in different states so please enter your state.

Facility or Health System where you will be placing students:(Required)

Name of Clinical Placement Coordinator (CPC):(Required)

This will be the primary contact person for TCPS for the program of study.

First Last

CPC Email:(Required)

CPC Phone:(Required)

Enter the phone number that is best for contacting you.

Phone Type(Required)

Should the Partnership Invoice be emailed to the CPC or someone else?(Required)

CPC

Another individual

No Invoice Alert: Each student will pay school's Partnership Fee for a total of $150/student! You will also indicate this on each student registration!

Enter the name of who should receive the TCPS Partnership Fee invoice :(Required)

First Last

Email for invoice:(Required)

Phone Number for Questions!(Required)

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MP Confirm Partnership

Confirm Your Partnership for AY2025-2026

Use this form to CONFIRM your Managed Partnership with TCPS!

Thank you for reaching out. We’ll be back in touch soon!