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Maryland Network Against Domestic Violence

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The password must have at least 8 characters, at least 1 digit(s), at least 1 lower case letter(s), at least 1 upper case letter(s), at least 1 special character(s) such as as *, -, or #

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Questionnaire

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Certified LAP Implementers - Is your organization a certified LAP Implementer?

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If you are a current certified LAP Implementer, please provide contact information on your original LAP jurisdictional partners. (Original LAP jurisdictional partners are agencies with whom you applied and approved for original LAP training)

LAP Team Coordinator Contact Information - A designated representative will serve as the Team Coordinator for this project and will coordinate with MNADV to fulfill the jurisdiction’s training and TA activities as necessary. If your organization has a LAP Coordinator, please complete the below information: Does your organization/jurisdiction have a LAP Team Coordinator?

Title / Rank (if applicable)

Agency/Program/Organization

Street Address

City

State

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Telephone Number

Email Address

Subscription Information - For which subscription type are you registering? Subscription Types (choose one): Single Jurisdiction (Any single jurisdiction that has already implemented the Maryland Model LAP as trained and recognized by MNADV. The single jurisdiction subscription includes all current implementing agencies in one jurisdiction). Multi-Jurisdictional (Any multi-jurisdictional project that has already implemented the Maryland Model LAP as trained and recognized by MNADV. The multi-jurisdictional subscription includes all current implementing agencies included in the current project. Any new expansion site will need approval by MNADV). Statewide Implementation (Any State that has already implemented the Maryland Model LAP as trained and recognized by MNADV. The Statewide subscription includes all current implementing agencies and the ability to expand to interested jurisdictions within your state. Any new expansion site will need approval by MNADV).

Subscription Length (choose one):

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