Our online application is undergoing maintenance as of March 3, 2024. Please download our member application from the link below or check back later. Thank you for your interest in applying!
An Individual must have a diagnosis of a mental disability, with an I.Q. of less than 70 to 75, depending on services requested. Third party sponsorship for funding or ability to pay for services must be established.
Click to Print and Mail the Application below. OR fill out and submit the form online and an application will be mailed to you.