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Apply for 2022 Member & Family Advisory Council

Apply for 2022 Member & Family Advisory Council

Join the Council

Thank you for your interest in joining the Member and Family Advisory Council! Please complete the application below.

If you have questions about the Member and Family Advisory Council , please contact mfac@lifeplanccony.com

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Applicant Name*
First Last
LIFEPlan Member Name*
First Last
Email*
Phone*
Region
Region
- Central New York
- Capital
- Mohawk Valley
- North Country
- Southern Tier
- Hudson Valley
County*
Care Manager
Why are you interested in joining the MFA Council?*
How would you like to participate in the Council?*
- Meetings
- Committees
- Helping with projects of interest
- Other
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