Applicant Type definition

Applicant Type means the type of account for which an applicant is applying for access to CURES, including only the following types: Prescriber, Out-of-State Prescriber, Non-DEA Practitioner, Pharmacist, or Out-of-State Pharmacist, or Delegate.

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Applicant Type. (Check all that apply) ☐ I am a current instructor – this is an expedited application ☐ I am applying as an independent trainer (not affiliated with org) I am applying as an agent of my employer ☐ Other (please specify: ☐ I identify as a person with lived experience or a person in long term recovery ☐ I support a family member with serious mental illness Organization Name: (if applying as an agent of your employer) Industry Type: (Check all that apply) ☐ Faith community ☐ Corporate ☐ Human Resources/Employee Assistance Program ☐ Law enforcement/Public Safety ☐ Higher Education ☐ Primary/Secondary Education ☐ Hospitality ☐ Older Adults Social Services ☐ Behavioral Health Care ☐ Other Health Care ☐ Government ☐ Other (please specify): How did you find out about the instructor training program? ☐ Employer email / Employer requirement ☐ Professional relationship ☐ Personal relationship ☐ Internet search ☐ Mental Health First Aid USA website ☐ Mental Health First Aid instructor ☐ Have taken the 8-hour course ☐ Other (please specify):

Applicant Type. [NTF: drop-down menu]

Examples of Applicant Type in a sentence

• H: Public/State Controlled Institution of Higher Education Type of Applicant 2: Select Applicant Type: Type of Applicant 3: Select Applicant Type: * Other (specify): * 10.

• COUNTY OF LOS ANGELES DEPARTMENT OF PARKS AND RECREATION ORI#: A0693 Authorized Applicant Type: Parks and Rec Vol/VCA Work/Park Location (Type of License/Cert/Permit or Work Title: VOL/AGENCY/PARK/TYPE/INITIALS OF ROLLER) Live–scan Requested and authorized by: (Name) (Emp #) Los Angeles County Dept.

• Calculation of the compensation payment differs by project phase and by Applicant Type, as explained below.

• If you select “Joint” as the Applicant Type, “Joint” tells us that you would like to add an Authorized Signer to your Health Savings Account.

• Date: ___________ Social Security or other identifying number Signature of Applicant Purchase Price including commissions, if any Name and Address of Applicant Type of Entity (check one): • Individual • Partnership • Corporation • Trust • Other (specify) Nationality (check one): • U.S. Citizen, Resident or Domestic Entity • Foreign Corporation • Non-resident Alien If the U.S. Citizen, Resident or Domestic Entity box is checked, the following certification must be completed.

• Date: Social Security or other identifying number Signature of Applicant Purchase Price including commissions, if any Name and Address of Applicant Type of Entity (check one): • Individual • Partnership • Corporation • Trust • Other (specify) Nationality (check one): • U.S. Citizen, Resident or Domestic Entity • Foreign Corporation • Non-resident Alien If the U.S. Citizen, Resident or Domestic Entity box is checked, the following certification must be completed.

• Refer to Table 2 (Contribution Percentages and Funding Award Commitment by Applicant Type) in Section 4.1 of the Funding Guidelines for information on Maximum Provincial Funding Amounts and Required Organization Contribution percentages.

• Choose an item., Program Name: Amount Requested: $ , Choose an item., , Applicant Type: Choose an item.

• Please refer to the list of mandatory supporting documentation by applicant type provided in Table 3 (Mandatory Supporting Documentation Based on Applicant Type) of the Funding Guidelines.

• Date: Social Security or other identifying number Signature of Applicant Purchase Price including commissions, if any Name and Address of Applicant Type of Entity (check one): ¨ Individual ¨ Partnership ¨ Corporation ¨ Trust ¨ Other (specify) Nationality (check one): ¨ U.S. Citizen, Resident or Domestic Entity ¨ Foreign Corporation ¨ Non-resident Alien If the U.S. Citizen, Resident or Domestic Entity box is checked, the following certification must be completed.

More Definitions of Applicant Type

Applicant Type means a category of applicant applying for a disposition program including a:

Applicant Type means any of: (a) Co-ops; (b) First Nation and Métis Communities; (c) Municipalities; and (d) Public Sector Entities, as applicable.

Applicant Type. Not for Profit Project Period: 9/1/2018 – 8/31/2020 Award Amount: $120,000 Project Title: Proyecto Agua Limpia

Applicant Type. Not for Profit (past EJ Small Grantee) Project Period: 9/1/2018 – 8/31/2020 Award Amount: $120,000 Project Title: Community Garden Network Monitoring and Public Education Project Project Location: West Broad Community, Athens, Georgia, 30606 Project Partners: Upper Oconee Watershed Network, Athens Clarke County Stormwater Management Program, Athens-Clarke County Extension Office

Applicant Type. (Check all that apply) ☐ I am applying as an independent trainer (not affiliated with org) ☐ I am applying as an agent of my employer.☐ I identify as a person with lived experience or a person in long term recovery ☐ I support a family member with serious mental illness Organization Name: (if applying as an agent of your employer) Industry Type: (Check all that apply) ☐ Faith community ☐ Corporate ☐ Human Resources/Employee Assistance Program ☐ Law enforcement/Public Safety ☐ Higher Education ☐ Primary/Secondary Education ☐ Hospitality ☐ Older Adults Social Services ☐ Behavioral Health Care ☐ Other Health Care ☐ Government ☐ Other (please specify): How did you find out about the instructor training program? ☐ Employer email ☐ Employer requirement ☐ Professional relationship ☐ Personal relationship ☐ Internet search ☐ Mental Health First Aid USA website ☐ Mental Health First Aid instructor ☐ Have taken the 8-hour course ☐ Other (please specify):

Applicant Type. □ Fox Township Organization □ Fox Township Resident □Non-Fox Township Organization □ Non-Fox Township Resident Describe Event (be specific): Date of Event: Food/Beverage Present? □ Yes □ No Start Time: End Time: Security Deposit: $ □ Paid Rental Fee: $ □ Paid