Applications

Successful outcomes begin when you meet with a service coordinator.

Individuals interested in seeking funding must complete an application. You may visit or call your local office for the form, or click on the button below to download the application.  Once completed, the application should be returned to your local office.

To qualify for funding, applicants must meet the following criteria:

  • Have a mental illness or intellectual and other development disability
  • Meet specified income and resource guidelines
  • Reside in the CICS 10-county region
  • Complete an assessment that shows need for service

Download Application