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2025-2026 "Connections"

Program Contract

Please complete all 4 pages and fill out all required fields to ensure proper registration submission. You should receive an email after submission.

*This Program is for Members of The Arc of Mid-Michigan ONLY

Check the box that pertains to you:
2 days a week: I am a current member of The Arc and will be attending The Arc “Connections” program 2 days a week @ a flat rate of $23.00 per week.
1 day a week: I am a Current member of The Arc and will be attending The Arc “Connections” program 1 day a week @ a flat rate of $15.00 per week.

Monthly payment schedule will be sent once form is submitted

Connections Fee Agreement will be from June 2025 through May 2026

Please check each point below

Date
Month
Day
Year
  • A signed fee agreement must be completed and on file prior to participation in the “Connections” Program.

  • Those needing one-on-one assistance or personal care must be accompanied by someone to assist them.

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