Rape Crisis Center and Organization Application


  1. Complete the application and click “SUBMIT APPLICATION”
  2. Click the Buy Now button to securely enter your credit card information - make sure you submit the right amount based on your organization.

Rape Crisis Centers or Organizational Memberships

Please complete and submit the following to join NCCASA or renew your NCCASA membership as a Rape Crisis Center or Organization. Completion of this form gives NCCASA express authorization to process payments using the credit card entered into PayPal.