IECMH Foundations Certificate Financial Aid Application

Thank you for your interest in the IECMH Foundations Certificate!

Please fill out the application and a member of our Workforce Development team will be in touch with you shortly. This information will help us determine if you qualify for support from grant funding from our generous supporters.

First Name

Last Name

Job Title

Agency or Organization

Workforce Sector

Main County You Work In

Please enter any other counties you work in.

# of children ages 0-5 (or families) your program serves annually (estimate is ok)

% of families your program serves that are eligible for Medicaid (estimate is ok)

Your salary range (this will remain confidential)

Form submission[]

IECMH Foundations Certificate Financial Aid Application

Thank you for your interest in the IECMH Foundations Certificate!

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