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Get Maine Form Application 2018-2024

County: Physical Address: City: Telephone No.: ( ) Fax No.: ( ) Email Address: SECTION 2: Fees Initial Application (1 Year) Renewal Application(2 years) Change to License & Fee A. Number of Adults/Consumers to be served at this program (Select one): Up to 10 consumers (fee $10 x year(s) 11 20 consumers (fee $20 x year(s) 21 30 consumers (fee $30 x year(s) 31 40 consumers (fee $40 x year(s) 41 or more consumers (fee $50 x year(s) Processing.

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