Grant Application

Name

Email

Phone Number

Mailing Address

Child’s Name

Child’s Date of Birth (YYYY-MM-DD)

Child’s diagnosis or explanation of current needs

How did you hear about us?

Has your family received support from Join the Fun Foundation before?

If yes, please describe:

Grant Request Category

If submitting a special Family Request, describe the experience you are seeking a grant for:

Why is this experience meaningful for your child and family?

Total estimated cost of experience

Provide an itemized breakdown of all costs associated with this experience (if applicable)

If your request includes tickets to an event or activity, specify exactly how many total tickets are needed. Include adults and children.

Does your child need special accommodations to fully participate?

If yes, please explain:

Why is support from the Join the Fun Foundation necessary to make this experience possible?

Please tell us about your child:

Current Therapeutic & Educational Supports (Please check all that apply):(required)

My child does not receive any specialized services My child has an Individualized Education Program (IEP) My child has a 504 Plan My child receives Early Intervention Services My child receives ABA, speech, occupational, or physical therapy My child is on the waitlist for ABA, speech, occupational, or physical therapy Other (Please describe below)

Please provide additional details if needed:

Annual Household Income

Please indicate any programs your child qualifies for (Please check all that apply)(required)

My child qualifies for Medicaid or CHIP (Children’s Health Insurance Program) My child qualifies for Free or Reduced-Price Lunch at school My family receives SNAP (food assistance) or WIC benefits My family is currently experiencing financial hardship Other (Please describe below) My child does not qualify for any of the of the above

Please provide additional details if needed:

If selected, are you willing to share a photo or short story about your child’s experience?

Is there any additional information you would like us to consider?

Please upload any additional documentation you would like us to review (optional)

Drag and drop or click to select a file.

I attest that all of the information I have provided is accurate, to the best of my knowledge.

Thank you for your application!