CLASP Annual Membership CLASP Application $25 ANNUAL FEE Question Title * 1. Type(s) of Service(S) Provided: Care Homes and other Licensed Group Living Supported Living or Independent Living Services Respite Day Program Supported Employment Other Employment Development Services Clinical, Consultation, Legal, etc. Children's Behavioral Health Adult Behavioral Health Administrative (FMS, Payee, Independent Facilitator, etc.) Early Intervention Services Family Foster Agency/Homes Crisis Services Dual Diagnosed Services Other (please specify) Question Title * 2. Type(s) of Service(S) Provided: Care Homes and other Licensed Group Living Supported Living or Independent Living Services Respite Day Program Supported Employment Other Employment Development Services Clinical, Consultation, Legal, etc. Children's Behavioral Health Adult Behavioral Health Administrative (FMS, Payee, Independent Facilitator, etc.) Early Intervention Services Family Foster Agency/Homes Crisis Services Dual Diagnosed Services Other (please specify) Question Title * 3. What Training Opportunities Would You Like CLASP to Provide or Arrange? How to Engage Your Legislators and Policymakers Management and Organizational Leadership Title 17 and Title 22 Regulatory Compliance Person Centered Planning and Thinking Business and Marketing Direct Support Professionals: Ethics and Core Competencies Health Related LGBTQ Issues Medication Courts and other Legal Issues Crisis Management Current State and Federal Budget and Other Legislation Employment Development Compliance with the HCBS New Rules Behavioral Supports Grant Writing Other (please specify) Question Title * 4. Membership Type New Member Renewal Question Title * 5. Contact Information Name Company Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Question Title * 6. Please Send Me or My Agency an Invoice Yes No Pay Now Done