To begin the application process you must first SIGN UP for a username and password click here.  Please complete all required fields [in red].  Once you have finished you may continue to the application, or log out and return later.  (Use the link at the bottom of this page to download and print a PDF of the submission procedures to refer to as you complete the application.)  Please keep a record of your username and password.   

This is an online application and all information you enter will be sent to us electronically.  Please complete all fields.  As you work, Save Draft so you don't lose content.  You can save and retrieve the form for editing but once submitted you can no longer make changes.

Be sure to read over your application, make any corrections and print a copy for your records before you hit the Submit button.  If your Submit button is not enabled, look to see that you have selected the Check to sign box.

The application packet consists of three parts:
      Part 1 (Application Form) and Part 2 (Program Description) are required;
      Part 3 (Supporting Materials) is optional. 

Submission procedures for each part are described below.  If you have any questions about the application process, call 703.907.8592.

Part 1.  Application/required.  Asks you to identify the applying program; the facility; program and facility director(s); contact information (populates from registration data you entered, please review for completeness); a description of the facility; and a brief statement of the program to be considered (under 100 words).

Part 2.  Program Description/required [document upload]. The description must be no more than six pages, double-spaced.  Include the program name on the top right hand corner of each page.

To upload this document, select Award Application as document type from the drop down menu, click on the Browse... button, identify the document in your system, select the file, then click the Upload button. The screen will refresh and you will see the file in the grid below the upload box.  Be sure to select the correct file for upload as files cannot be deleted.

The program description must address the following 9 elements:
A.    Verification that the submission is an ongoing program.
B.    Evidence that the program has made a significant contribution to the field of mental health on a local or national level.
C.    Evidence that the program provides a model for other mental health programs.
D.    Evidence that the program is innovative.
E.    Description of ways staff has overcome obstacles and barriers or has extended resources and funding.
F.    Verification of the program’s effectiveness and focus on quality improvement through use of quality assurance measures, quality improvement methods, UR, outcome measures, etc.
G.    Documentation of the program’s staffing and the role of each staff member, including the role of the psychiatrist in the program.
H.    Documentation of involvement of consumers and/or family members.
I.      A list of the program’s funding sources during the last fiscal year and the amounts of the funding.

Part 3.  Supporting Materials/optional [document upload].  E.g., abstracts of research studies, publications, photographs, and news clippings.  Supporting materials may not exceed 5 pages and should be relevant.

To upload supporting materials select Other Documents as document type, click on the  Browse... button, identify the document in your system, select the file and click the Upload button.  The screen will refresh and you will see the file in the grid below the upload box. Repeat for each document.  Be sure to select the correct file for upload as files cannot be deleted.