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Innovative Solutions for People with Disabilities to Achieve Integrated Life Outcomes Grant
Partner Application
Company
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First Name
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Last Name
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Street Address
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Address Line 2
City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Phone Number
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Email Address
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How are you currently helping the people you support develop relationships and expand or deepen their interests?
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If chosen as a partner, what do you foresee the biggest barrier will be to successfully help people develop and expand their relationships?
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Name of your agency’s point person for this project, if your agency is selected
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How many hours per week does your point person have available to lead this project within your organization?
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