Sign Up
To register with AATakeCharge you must complete an Individualized Workplan and Contract (IWP) and mail it to us. If you have difficulty with Option 1, try Option 2, or 3 (in that order). These formats will work, but they are slightly more difficult for us to process. We must conduct a one-on-one counseling with you before we can sign your IWP so please be sure to provide accurate contact information.
Option 1
Click here to obtain an Adobe PDF copy of the form. (This will work for about 90% of users.)
Once the form opens, you must click on the picture of the printer which you will see on the top left-hand side of your screen in order to print it out.
If your computer tells you to download the free Adobe Reader in order to access the Adobe format, click here to download Adobe Reader.
Option 2
Save the form as a Microsoft Word document (.doc)
Option 3
If you are having difficulty printing this form, ask for help. If you do not have a printer connected to your computer, we will mail a form to you. You must allow 2 weeks for delivery.
To have a TakeCharge Registration Form mailed to you, send an email to takecharge75@gmail.com with the address to which you would like the form mailed.