Family Support & Respite Renewal Application (FY2026–2027)
Thank you for applying for Family Support Funding with Georgia Community Support & Solutions dba InCommunity. Please verify and review that you have received family Support Funding for the 2025-2026 funding year. If you received funding, please continue. If not, you will have to submit a new application with our Agency.
Please only submit this application if you were approved for the 2025/2026 Fiscal Year
Please complete all of the fields that are on the form and click on the SUBMIT button on this document. DO NOT PRINT this document and submit it to our office. We will not accept any documentation that is faxed, mailed, or emailed submitted to our office. We retain the right to adjust or to amend funding amounts or verbiage on this form at any time. ATTENTION: Deadline to complete electronical renewals is on or by June 24, 2026. NO EXCEPTIONS. You will receive your approval letter on or by July 1, 2026, which starts the fiscal year. We wish you the best of luck and have a great summer. :)
Applicant & Contact information
Submission Date
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Month
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Day
Year
Date
Name of the Individual receiving services
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First Name
Last Name
Date of Birth of Individual
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Month
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Day
Year
Date
Primary Email
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example@example.com
Secondary Email
example@example.com
Home Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County of Residence
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Phone Number
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Area Code
Phone Number
Secondary Phone Number
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Area Code
Phone Number
Parent/ Guardian Information
Parent/Guardian Submitting this form
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First Name
Last Name
Relationship to Applicant
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Applicant Overview
Please provide a brief description of your individual.
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What developmental disability diagnosis does your individual have?
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What needs are important to the individual?
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Please describe how this funding will benefit the individual.
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What needs are most important to the family?
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Please Describe how this funding will benefit the family.
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Funding Program Category Selection
Please indicate the type of funding you are requesting for the 2026/2027 FY( Please select one, please note Respite will NOT automatically be added if you do not select the option)
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Family Support Funding Only
Respite Funding only
Both Family Support and Respite Funding
Funding Usage & Request
Please indicate below the estimated amount of Family Support funding utilized during the 2025/2026 Fiscal year.
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Please indicate below the estimated amount of Respite funding utilized during the 2025/2026 Fiscal year.
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Please indicate below the estimated amount of Family Support funding you plan to utilize during the 2026/2027 Fiscal year.
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Please indicate below the estimated amount of Respite funding you plan to utilize during the 2026/2027 Fiscal year.
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Please select your top two or three priority categories you would like to utilize your Family Support funding for the 2026/2027 FY
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Community Access
Recreational/Social Intergration
Dental Services
Specilaized Medical Supplies & Specialized Clothing
Nutrition
Behaviroal Support & Consultation
Specialized Equipment
Home Health Services
Environmental Modfication
Theraputic Services
After School Care
ABA Therapy
Incontinent Supplies
Job Skills Training
Summer Camp
Other
Current Services & Resources
List all current services/ resources utilized by the individual and family below.
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New Options Waiver( NOW)
Currently on DBHDD Planning List
ICWP
CCSP
Deeming Waiver(Katie Beckett)
Vocational Rehabilition
Food Stamps
Individual Educational Plan (IEP)
ADRC-Options Counseling
Comprehensive Waiver(COMP)
SOURCE
GAPP
DBHDD State Funded Services
Child Care Assistance
Adoption Assistance
Social Security Disability(SSDI)
Other
Other Agency Involvement
Are you currently receiving or on a waiting list for Family Support or similar services with another agency?
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Yes
No
I am not sure
If yes, please list the agencies below?
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Have the services or goods requested in this application been denied by another agency?
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Yes
No
I am not sure
If yes, please provide additional details.
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Supporting Documentation
Please read below
Please upload your current approval letter and IFSP for the current 25/26 Fiscal Year (proof of funding).
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Browse Files
Cancel
of
Please upload a current photo of your indiviudal "if" you would like to share with our team.
Browse Files
Cancel
of
Feedback
Please share any positive feedback below for our team or leave us a review.
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Please share any additional information, comments or suggestions.
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Acknowledgement & agreement
By submitting this application, you acknowledge and agree to the following: Family Support Services are non-entitlement, state-funded services designed to assist individuals diagnosed with intellectual and/or developmental disabilities (I/DD). Submission of this application does not guarantee funding approval. Funding amounts are not guaranteed and may increase, or decrease based on available program funding Eligibility. Award determinations are based on multiple factors, including but not limited to: Timing of program entry from the prior fiscal year, funding usage, program allocations and or demonstrated needs of the individual and family. Georgia Community Supports & Solutions dba Incommunity, has the right to withdraw awarded Family Support Funds if they are not utilized within the first 90 days of the signed Family Support Plan. I/ We attest that we are informed of our right to participate in the development of this Individualized Family Support Plan, and were give the ability to identify the services and goods based on my/our family priority of needs for services/ goods By proceeding, you confirm that all information provided is accurate and complete to the best of your knowledge.
Please Read Below
By submitting this application, you acknowledge and agree to the following: Family Support Services are non-entitlement, state-funded services designed to assist individuals diagnosed with intellectual and/or developmental disabilities (I/DD). Submission of this application does not guarantee funding approval. Funding amounts are not guaranteed and may increase, or decrease based on available program funding Eligibility.02-401
Please Read Below
Award determinations are based on multiple factors, including but not limited to: Timing of program entry from the prior fiscal year, funding usage, program allocations and or demonstrated needs of the individual and family. Georgia Community Supports & Solutions dba Incommunity, has the right to withdraw awarded Family Support Funds if they are not utilized within the first 90 days of the signed Family Support Plan.
Please Read Below
I/ We attest that we are informed of our right to participate in the development of this Individualized Family Support Plan, and were give the ability to identify the services and goods based on my/our family priority of needs for services/ goods By proceeding, you confirm that all information provided is accurate and complete to the best of your knowledge.
Signature
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Submit
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