Thank you for submitting a proposal for a MPN affiliate.
Please answer each question carefully and completely.

Montana's Peer Network has a mission to lead the expansion and development of recovery oriented behavioral health services. Your proposal will be heavily weighed against this mission. We believe that the development of affiliates across Montana can assist in achieving our mission.
Our Board of Directors meets monthly so depending on when the application is submitted it may take up to 4 weeks for review. Please be patient. 
Once approved your proposal will be given to the Affiliate Development Committee who will contact you for a meeting to discuss further details, answer questions and move the process to the next step.
We require an annual fee for all affiliates. The fee is flexible and is based on the proposed affiliate size and scope. The fee will vary for each affiliate.
If your proposal is approved you will be required to sign a "memo of understanding" (MOU) between MPN and your affiliate. The MOU will contain the details of this arrangement agreeable to both parties. You cannot become an affiliate without a MOU. We only seek win-win collaborations.
If your application is denied you will receive a explanation as why it has been denied. You are always eligible to re submit.

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* 1. Name of proposed affiliate.

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* 2. What is the legal business status of the proposed afiliate?

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* 3. Name of contact person

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* 4. What is the contact person (s) email address?

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* 5. What is the phone number of the contact person?

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* 6. What is the address of the proposed affiliate?

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* 7. What is the website of the proposed affiliate? If you have one.

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* 8. What is the area of focus for the proposed affiliate?

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* 9. Why are you interested in having a MPN Affiliate?

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* 10. Do you agree to pay an annual affiliate fee to MPN? The fee is based on the scope and size of the proposed affiliate.

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