Skip to content

Howard County Family Leadership Program Application (Fall 2026)

Please complete this application to apply for the Family Leadership Program. Once submitted, a member of the program staff will reach out to discuss your application further. Please remember that space is limited so not all applicants will be accepted into this cohort. If you do not meet the eligibility requirements or are not selected for the program, you will be notified by email.

All responses you provide on this application will remain confidential and seen only by program staff. The information provided though helps us ensure that the program addresses your family's specific needs.

Eligibility
You must be a parent or caregiver to a school-aged child with mental health challenges.
You must be a Howard County resident.
You must be willing to commit to attending both days of the event.


Program Dates:
Friday, October 23, 2025 - 5:00 pm - 9:00 pm
Saturday, October 24, 2025 - 8:00 am - 4:30 pm


1.Your First Name
2.Your Last Name
3.Email Address
4.Telephone Number(Required.)
5.Are you a resident of Howard County?
6.Home Address (Applicants must be Howard County residents)
7.Race
8.Ethnicity
9.Are you the parent or caregiver to a school-aged child with mental health challenges?
10.What is your role in relation to the child?
11.How old is your child with mental health challenges?
12.Has your child been diagnosed by a physician with a specific mental health challenge? Note: A specific diagnosis is not required to participate in the program.
13.If yes, what mental health diagnosis has your child been given?
14.If no, what behaviors does your child exhibit that lead you to believe they might have a mental health challenge?
15.Is your child enrolled in school?
16.If your child attends a Howard County Public School, what is the name of the school?
17.What grade is your child in?
18.Does your child have an IEP (Individualized Education Plan)?
19.Does your child have a 504 Plan?
20.What are your child's challenging behaviors either at home or at school?
21.What concerns do you have about the supports and services your child is receiving at school?
22.What mental health services is your child receiving in the community, outside of school?
23.Are there additional services you think would be helpful for your child that they aren't currently receiving?
24.As the parent or caregiver, what support do YOU need to help you take care of your own health and wellbeing while managing your child's challenges.
25.What are your goals for attending the Family Leadership Program? What knowledge or skills do you hope to gain? What questions to you hope to have answered?
26.This is a 2-day program that has the most benefit when parents and caregivers attend all the workshops held on both days. Do you foresee any challenges attending for the entire 2 day program? Note: If you are unable to commit to attending both days (October 23 and October 24th), consider waiting for the next offering. Preference will be given to those who can commit to attending both days.
27.To promote self-care and provide some respite, MCF covers the cost of the your hotel room for the evening of Friday, October 23rd.

Would you like to stay in a room at the hotel?
28.MCF can provide limited funds (up to $40/day) to help pay for childcare so that you can attend the event. Please note: Children are not permitted to attend the program. This ensures that all participants are able to gain the maximum benefit from the opportunity to learn, grow, and connect.

The funds will be paid to a childcare provider of your choice (family, friend, or other). The provider will be required to complete a W9 in order to receive payment.

Will you need this financial assistance?
29.If you need transportation support to get to and from the hotel, MCF can cover the cost of an Uber ride.

Will you need this financial assistance?
30.What else would you like us to know about you, your child, or your family?