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Pay it Forward Low Income Fund Application
Here at GRIT, we're committed to helping riders afford the mobility they need to move beyond the pavement. We've created the Pay it Forward Low Income Fund to help riders in difficult financial situations afford a GRIT Freedom Chair.

The fund is endowed by private donations, GRIT's contribution of 10% of each sale of the GRIT Freedom Chair Forward, and proceeds from our customer referral program.

Applications for grants from the fund will be reviewed by the GRIT team. Selected beneficiaries will receive a grant to help cover much, but not all, of the cost of a refurbished GRIT Freedom Chair. These chairs have been lightly used, and have been inspected, refurbished, and certified by the GRIT assembly team. Currently, we're forecasting that we'll be able to subsidize around 5 chairs per year. The fund is new and we're working on strategies to increase the fund so that we can help more people. If you're applying to the fund, we also recommend checking out the financing options on our website: www.gogrit.us/financing. If you have any questions about this application, the fund, or other financing options, please call us at 1-877-345-4748. We're happy to work with you to find the best solution for your specific situation.

There are six sections of this application. We expect it will take 30 minutes or less to complete. It's not possible to save the application and come back to it later. To view all of the application questions so that you can work on it offline, please click here: http://bit.ly/2bnuryZ. Only applications submitted online using this Google Form will be reviewed.

This application is only open to residents of the United States.

What is your legal name?
As printed on a driver's license or other form of government issued identification.
Your answer
What is your phone number?
Your answer
What is your email address?
Skip this question if you do not use email.
Your answer
What is your ZIP code?
Your answer
What is your date of birth?
Your answer
Are you a veteran of the US Armed Forces?
How did you learn about the GRIT Freedom Chair?
Your answer
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