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 :

38-50 Bell BLVD. Suite A2
Bayside, NY 11361
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For more information, call (718)224-8197  ext. 3
Name of Parent (Guardian) *
Name of Student *
Address *
Age of Student *
Disability Category *
Telephone Number of Parent (Guardian) *
Email Address of Parent (Guardian) *
Year of high school graduation *
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.
Name of the fiscal intermediary (FI) and telephone number.
Currently enrolled programs/services (check all that applies)
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