Transition Program @ CIDA Application Form
After completing this form, please send the final IEP, the recent psychological test report and Life Plan (if have one) to :

CIDA
38-50 Bell BLVD. Suite A2
Bayside, NY 11361

For more information, call (718)224-8197 ext. 3
Name of Parent (Guardian) *
Your answer
Name of Student *
Your answer
Address *
Your answer
Age of Student *
Your answer
Disability Category *
Telephone Number of Parent (Guardian) *
Your answer
Email Address of Parent (Guardian) *
Your answer
Year of high school graduation *
Your answer
Highest education *
Do you have an active Self-Direction budget from OPWDD? *
If yes - please provide the name of your broker, their telephone number, & email address.
Your answer
Name of the fiscal intermediary (FI) and telephone number.
Your answer
Currently enrolled programs/services (check all that applies)
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