The Curb Free Foundation Travel Grant Application
When you submit this form, we will receive your responses. We will keep your information on file for one year, so only one submission is needed per calendar year. Unfortunately, due to a high number of submissions, we cannot provide travel grants to everyone that enters, but know that we do tremendously appreciate you submitting this form and we hope that we can help you take your dream trip.
Sign in to Google to save your progress. Learn more
Email *
What is your phone number? *
What is the full legal name of the grant applicant? If you are filling this form out on behalf of someone else, please write their name. *
What is the age of the applicant? *
Please describe the disability of the travel grant applicant. *
Does the applicant use a wheelchair during their everyday life? *
Where does the applicant live? Please list city and state. *
If chosen, would the applicant travel solo or with a care attendant(s)? If traveling with a care attendant(s), does the applicant have someone willing and able to travel with them? *
Now to the fun part… where does the applicant want to travel to if they win this travel grant?? *
Why does the applicant want to visit that destination? *
How would winning this travel grant help the applicant to be able to take this trip? *
How much do you estimate that this trip would cost? *
Is the applicant able to take this trip within the next 12 months? *
Do you agree to share photos from your trip and descriptions with us if you receive a travel grant? *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
GoogleForms
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google.