V.I.P. Scholarship Application

VITAAL‑K™ Implementation Program (V.I.P.)

Directions:

Thank you for your interest in joining the V.I.P. Team — a selective cohort of licensed clinicians partnering with TAG to pioneer movement‑based literacy therapy in real‑world clinical settings.

Please complete the application below. Acceptance into the V.I.P. Program includes a full scholarship for VITAAL‑K Level One Certification and is based on your professional expertise and the unique contribution you commit to making toward TAG’s clinical infrastructure.

Contact Information

First name

Last name

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Clinician information

Area of licensing

NPI Number

Personal statement

What interests you most about VITAAL‑K and movement‑based literacy therapy?

Contribution to TAG VITAAL-K

Each V.I.P. clinician is selected based on a specific professional contribution they will make to strengthen VITAAL‑K’s implementation, infrastructure, or clinical ecosystem. This contribution is made in lieu of tuition and is a condition of maintaining active V.I.P. status.

Examples include (but are not limited to):

Designing or refining TAG’s data‑collection and case‑study systems
Supporting school‑based training or professional development
Helping integrate VITAAL‑K with occupational therapy or speech‑language therapy
Assisting with fidelity tools, implementation guides, or clinical resources
Contributing to research summaries, case documentation, or pilot studies

What specific contribution or contributions do you propose to make as part of your V.I.P. membership?

Multi choice

Designing or refining TAG’s data‑collection and case‑study systems

Supporting school‑based training or professional development

Helping integrate VITAAL‑K with occupational therapy or speech‑language therapy

Assisting with fidelity tools, implementation guides, or clinical resources

Contributing to research summaries, case documentation, or pilot studies

Other

Even if you have chosen multiple contributions, identify the best contribution you are capable of making. Then explain why this contribution is a strong match for your expertise.

Program Expectations & Agreement

Please review the expectations below.

V.I.P. clinicians must:

Complete the VITAAL‑K Level One Instructor Course
Sign TAG’s Independent Provider Agreement
Participate in structured implementation feedback and fidelity checks
Make ongoing, good‑faith progress toward the professional contribution identified in this application

Confirmation

I understand that V.I.P. membership is awarded in lieu of tuition and that ongoing progress toward my stated contribution is required to maintain active status in the program.

I have read and understand the expectations of the VITAAL‑K V.I.P. Program.

If accepted, are you prepared to begin the VITAAL‑K Level One Certification within the next 30 days?

If you cannot begin within the next 30 days, please explain.

SUBMIT APPLICATION

Your application will be reviewed by the TAG team. Your application will be reviewed by the TAG team. If selected, you will be notified regarding the next steps for activating your V.I.P. membership.