Stakeholder Membership Application
About Applied Self-Direction
Applied Self-Direction supports states, agencies, and managed care organizations with offering self-directed services to older adults, people with disabilities, and individuals with behavior health diagnoses. As the Technical Assistance and Training arm of the National Resource Center for Participant-Directed Services (NRCPDS), we have more than two decades of experience developing, implementing, and expanding self-direction. At Applied Self-Direction, our mission is to promote self-direction so individuals have the choice and control to live the lives they want.
Terms of Membership
Stakeholder Membership is an organizational membership, not an individual membership. Stakeholder Membership is open to any organization that does not meet the requirements of FMS or Program Membership. A member may withdraw from membership at any point during the year. However, dues are nonrefundable. The membership dues structure is subject to change on an annual basis. The applicant organization will pay the dues within 30 days of invoice. If no payment is received after 30 days, membership will be suspended until payment is received. Membership begins immediately upon approval of your application and for one year. Applied Self-Direction reserves the right to refuse membership to any organization and to not renew an organization if the organization no longer meets the criteria for membership. The inclusion of member benefits linked to third parties does not imply Applied Self-Direction endorsement of the program, entity, products, or services. Applied Self-Direction does not warrant, or otherwise take responsibility for the content of materials provided by third parties.
Membership Approval Process
Please allow approximately 2 weeks to process your application. Your organization's executive and billing contacts will be notified via email once your membership has been accepted.
Never submit passwords through Google Forms.
This form was created inside of Applied Self-Direction.
Terms of Service