Self-Determination Program Intake Form
This form is intended to gather information regarding program funding through the Regional Center and Self-Determination Program (SDP). We are actively vendored with several Financial Management Services (FMS) that provide funding for SDP participants. However, we are not vendored with Regional Centers, but oftentimes they authorize funds specifically for summer camps. Contact your service coordinator for more information.

The benefits of utilizing SDP funds for Friendship Foundation programs is that you can register for programs using funds provided by the SDP program. To get started, we will need a completed intake form to start the vendor process with your FMS company. We provide social and recreational programs under the regional center service code 331 - Community Integration Support.

To get started:
  1. For new participants: create a DaySmart profile
  2. Submit this intake form
  3. Determine your FMS Company and SDP budget for Friendship Foundation programs
FF will contact you to complete the following:
  1. Complete FMS vendor enrollment with FF
  2. FF will set up invoice(s) for you based on your monthly program budget (summer camps are billed separately)
  3. FF receives payment directly from FMS company/Regional Center. FF will then add a "credit" to your DaySmart profile to use towards programs.
*PLEASE NOTE: Program fees are due at the time of registration. If your child's FMS company or Regional Center cannot submit payment within 60 days from the invoice date, parents are responsible for paying the program fees. If invoices are issued after you pay for programs, we can submit a refund to you once the FMS company sends us payment. 

If you are unable to utilize Regional Center/SDP funds, the Friendship Foundation can offer financial assistance. You can apply here. 

Send us an email or give us a call at (310) 214-6677 if you have any further questions.
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Email *
Parent/Guardian Name *
Participant Name *
Best phone number to reach you *
Are you currently enrolled in the Self-Determination Program? *
If yes, what is your Financial Management Service (FMS) company? 
Write N/A if not applicable.
*
If no, are you planning on enrolling in SDP? If so, when? 
Write N/A if not applicable.
 *
With which Regional Center are you registered? *
What Friendship Foundation programs do you currently attend in a month (excluding summer programs)? *
What additional programs would you like to attend in a month (excluding summer programs)? *

What is your estimated monthly/annual budget allocated for FF programs based on your SDP budget? Please clarify if this is a monthly or annual budget amount.

 *
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