Apply for Member and Family Advisory Council (MFAC) Apply Here Name(Required) First Last Phone(Required)Email(Required) Preferred Contact (choose one)(Required) Phone Email Are you a LIFEPlan(Required)Member/Self-AdvocateFamily MemberRepresentative/AdvocateRegion(Required)CapitalCentral New YorkHudson ValleyMohawk ValleyNorth CountrySouthern TierEthnicity(Required) Black or African American Asian Native Hawaiian or Other Pacific Islander White Other Choose One(Required) Hispanic or Latino Not Hispanic or Latino Preferred Language(Required)How long have you been involved in services for yourself/your loved one?(Required)0-55-1010-1520+ yearsWhy do you want to join the MFAC?(Required)What special interests, skills or experience can you offer to the MFAC?(Required)Are you affiliated with any other groups or organizations that could be helpful to the MFAC?(Required)What areas do you have the most experience with?(Required) Self-Direction Community Habilitation Day Habilitation OPWDD Certified Setting (IRA, etc.) Employment Respite Family Support Services Environmental Modifications/Adaptive Technology Behavioral Health/Mental Health Services Complex Medical Conditions Other If other, please explain