Get Program Member Application - Boston College - Bc

This guide provides clear and comprehensive instructions for completing the PROGRAM MEMBER APPLICATION for Boston College. Whether you are a state agency interested in participant-directed programs or an individual assisting them, this step-by-step approach is designed to make the application process simple and straightforward.

Follow the steps to successfully complete your application.

1. Click the ‘Get Form’ button to access the application form and open it in your preferred editor. This initiates your application process.
2. Complete the 'Program Information' section. Enter your state agency name and web address. Indicate whether your agency currently administers a participant-directed program by selecting 'Yes' or 'No'. If you select 'No', briefly describe your plans to develop a participant-directed program.
3. Provide additional details about your participant-directed program(s). Fill in the program name, start year, populations served, approximate number of participants, and funding mechanism. Choose the program's model of participant direction and financial management services utilized.
4. Fill out the 'Agency Representatives Information' section. Provide contact information for two agency employees who will serve as primary contacts. Include their name, title, work address, city, state, zip code, phone number, email, and primary areas of responsibility.
5. In the 'Payment Information' section, select your payment option. You can choose to make a payment by check or receive an invoice. Ensure to fill out the contact information for your agency's financial representative.
6. Review the 'Terms of Program Membership' to understand membership duration, dues structure, and payment obligations. Make sure to adhere to these guidelines during your application process.
7. If applicable, provide information about any additional participant-directed programs in Attachment A, including their program name, start year, population served, and funding mechanisms.
8. Once you have completed all sections of the form, save your changes. You can download the completed form, print it out, or share it as needed.

Begin your application process online today to become a program member!