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APPLICATION FOR MHSC MENTAL HEALTH SERVICES ACT (MESA) SERVICES COMMITTEE .NAME: FIRST MIDDLE LAST ADDRESS: Day Cell () () PHONE: EMAIL: Organization (if applicable): REPRESENTATIVE STATUS : Please
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The MHSA Services Committee Application is a form that needs to be filled out in order to apply for services provided by the Mental Health Services Act (MHSA) Committee.
Any entity or organization seeking to receive funds or services from the MHSA Services Committee is required to file the MHSA Services Committee Application.
To fill out the MHSA Services Committee Application, you need to provide the required information as specified in the form. This may include details about your organization, the services you intend to provide, and any supporting documents or evidence.
The purpose of the MHSA Services Committee Application is to allow entities or organizations to request funding or services from the MHSA Committee. It helps in evaluating the eligibility, need, and feasibility of the proposed services.
The specific information that must be reported on the MHSA Services Committee Application may vary, but generally, it would include details about the organization, the services being sought, the target population, budgetary considerations, and other relevant information as specified in the form.
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