Bertha Mead Mini-Grant Application
Grants of up to $100 may be awarded to foster children who reside in a foster home that is affiliated with the Allison Area Foster Parent Support Group to provide items that would not normally be covered by the foster care payments or Medicaid.

Requests that would qualify for grant dollars would include items such as musical instruments, senior pictures, class rings, summer camp, prom expenses, class trips, a bicycle, swimming pass, etc.
Email address *
Date of Application *
MM
/
DD
/
YYYY
Child's Name *
Your answer
Child's Age *
Your answer
Foster Parent Name *
Your answer
Address *
Your answer
Phone Number *
Your answer
Child's DHS Social Worker *
Your answer
Worker's Phone Number *
Your answer
Full description of the request *
Your answer
Amount requested (itemized) *
Your answer
Have you applied to other sources for funding this request? *
If the request is approved, whose name should appear on the check? *
Your answer
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