DD-PIT Application Return Home Click for a printable application Developmental Disabilities Practice Improvement Team (DD-PIT) Application Name* First Last City*County*Phone*Email* Organization (If applicable)Position within organization (If applicable)Are you 18 years or older?*YesNoDo you identify as a person with an intellectual or developmental disability?*YesNoDo you currently receive services from a CMHSP?YesNoHave you ever received services?YesNoWhen is the last year?Application Over, Please ExitDo you use self-directed services (self-determination)?YesNoWhich category are you applying to fill?*First ChoiceSecond ChoiceThird ChoiceWhy would you like to join the DD-PIT?*Please describe relevant experience and/or expertise, that would make you a valuable and contributing member of the DD-PIT. Share your experience with person-centered planning, self-determination, and family and youth guided principles.*Do you commit to uphold the Mission and Vision of the DD-PIT?*YesNoDo you have access to a laptop, tablet, or smartphone to attend virtual meetings?*YesNoDo you need support to use a laptop, tablet or smartphone to attend virtual meetings?*YesNoDo you have wi-fi access (internet service)?*YesNoDo you need any accommodations to fully participate in DD-PIT virtual meetings?*YesNoPlease describe the accommodation you need to virtually participate in DD-PIT meetings.NameThis field is for validation purposes and should be left unchanged.
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