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New Providers Application Process for Choice, SSBG and Title 3 Programs

  • Complete new provider application packet and return as indicated on the packet checklist.

  • New providers must currently be serving at least one client under another funding source to be considered for application.

  • The establishment of a contractual agreement provides no guarantee of referrals for service delivery.

  • Request for a complete application packet, including the contract, and any questions can be directed to:

Beth Krudop, VP of Administration

8101 W. Jefferson Blvd.
Fort Wayne, IN 46804

Or via email at

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