2026 Application for the Virginia Individual and Family Support Program (IFSP) State and Regional Councils Nominee Information DBHDS is pleased to announce that it is accepting self-nominations for the IFSP State and Regional Councils! Please complete this form to nominate yourself for consideration on an IFSP State or Regional Council.This application is for people with developmental disabilities and/or self-advocates.Before applying, please review the State Council position description, Regional Council position description, the IFSP State Plan, the IFSP State Council Charter, and the IFSP Regional Council Charter. Question Title * 1. Please confirm that you are a person with a developmental disability and/or self-advocate. Yes No Question Title * 2. Are you currently on Virginia's DD Waivers Waiting List? Yes, I am on the DD Waivers Waiting List. No, I am not on the DD Waivers Waiting List, but I receive DD Waiver services. No, I am not on the DD Waivers Waiting List and I do not receive DD Waiver services. Question Title * 3. Which IFSP Region are you applying for? You must live in the region for the Council you wish to join. IFSP State Council members also serve on their IFSP Regional Councils. Western Region (Region 1): Albemarle, Alleghany, Amherst, Appomattox, Augusta, Bath, Bedford, Buena Vista, Campbell, Caroline, Charlottesville, Clarke, Covington, Culpeper, Fauquier, Fluvanna, Frederick, Fredericksburg, Greene, Harrisonburg, Highland, King George, Lexington, Louisa, Lynchburg, Madison, Nelson, Orange, Page, Rappahannock, Rockbridge, Rockingham, Shenandoah, Spotsylvania, Stafford, Staunton, Warren, Washington, Waynesboro, and Winchester Northern (Region 2): Alexandria, Arlington, Fairfax, Falls Church, Loudoun, Manassas, Manassas Park, and Prince William Central (Region 4): Amelia, Buckingham, Charles City, Charlotte, Chesterfield, Colonial Heights, Cumberland, Dinwiddie, Emporia, Goochland, Greensville, Hanover, Henrico, Hopewell, Lunenberg, New Kent, Nottoway, Petersburg, Powhatan, Richmond City, Prince Edward, Prince George, Surry, and Sussex Question Title * 4. Name Question Title * 5. Address Question Title * 6. Your email address (please use a reliable email address that you check regularly!) Question Title * 7. Your phone number Question Title * 8. What are your pronouns? (For example: she/her, he/him, they/them, she/they, he/they) Question Title * 9. IFSP Councilmembers serve as ambassadors for the IFSP, and share information about the program with their communities. Are you familiar with any of the IFSP resources below? Check all that apply. The IFSP-Funding Program The IFSP State Council and/or IFSP Regional Coucnils Peer mentoring through The Arc of Virginia Family mentoring through the Center for Family Involvement (CFI) at VCU The My Life, My Community website and call center I don't know anything about the IFSP. Question Title * 10. Which IFSP Council are you applying for? The IFSP State Council (read the State Council member description) The IFSP Regional Council (read the Regional Council member description) Next
