Funding request form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Members can apply for our funding request program by May 15th, 2024 to access up to $500 per individual. Our new biannual funding request program is intended to promote social inclusion and equitable access. Requests must be related to disability; examples include, but are not limit to, travel, equipment, technology, programming, and transportation. New this funding round, we have a designated fund for BIPOC members! As an Anti-Racism Microgrant recipient, we are delighted to introduce this new funding stream for 2024.

Logo: Logo for the PEI Cerebral Palsy Association

First and last name: *

Funding request stream: *

General stream.

Stream for BIPOC Members.

Required

Email: *

Mailing address: *

Describe the purpose of requested funds: *

Amount requested: *

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms