Autism Ontario Simcoe County Social Fund
PLEASE READ CAREFULLY BEFORE SUBMITTING AN APPLICATION

Applications will be accepted until March 31, 2019 and selected families will be notified by April 30, 2019

THE AUTISM ONTARIO SIMCOE COUNTY SOCIAL FUND APPLICATION IS FOR FAMILIES LIVING IN SIMCOE COUNTY WHO ARE SUPPORTING AN INDIVIDUAL DIAGNOSED WITH AN AUTISM SPECTRUM DISORDER

This is a reimbursement fund of up to $500 to be used to help offset the costs associated with caring for an autistic family member. We will reimburse for programs which assist in social skills development including:
- Recreational programs
- Private therapies which assist with social development, speech, self regulation, anxiety, behavioural intervention etc.
- Sensory equipment/weighted blankets
- Social Skills programs
- Camps (day or overnight)
- Kinark Outdoor Center Family Camp
We will NOT reimburse:
- Transportation costs, mileage, parking fees
- Activity costs (admission fees, costumes, snacks, etc)
- Home care and cleaning costs
- Education fees (tutoring, post secondary or private schooling)
- Daycare costs
- Medication costs

This funding is meant to serve as an enhancement for families to access private therapies, camps and programs in their community. Families can only apply for these funds once a year and there is no guarantee of the availability of these funds in future years.

Our Chapter receives NO government assistance. Funding is dependent on our fundraising efforts and general donations from our community.

All applicants selected are required to assist the Chapter by volunteering a minimum of 5 hours/year or support one of our fundraising efforts.

ONE APPLICATION PER ASD INDIVIDUAL - OPEN TO ALL AGES!

Email address *
Last Name of Person Completing this Application *
Your answer
First Name of Person Completing this Application *
Your answer
Phone Number *
Your answer
Alternate Phone Number
Your answer
Full Mailing Address including Postal Code *
Your answer
First Name of Individual Diagnosed with ASD *
Your answer
Last Name of Individual Diagnosed with ASD
Your answer
DOB of Individual Diagnosed with ASD *
MM
/
DD
/
YYYY
Your relationship with the individual diagnosed with ASD *
Please indicate what receipt you intend to submit for reimbursement (up to $500) *
Required
Please elaborate on type of program or support you are requesting reimbursement for. Include the frequency that you are accessing this type of program and cost. Include the cost of specific program/sensory equipment you need financial assistance for. *
Your answer
If selected for this funding, do you agree to assist the Chapter by volunteering or supporting our fundraising efforts? *
If a member of your family has been volunteering this year, please indicate in what capacity *
Required
I understand I am not guaranteed to receive funding as applications are reviewed by a selection committee. *
Any additional information we should be aware of?
Your answer
A copy of your responses will be emailed to the address you provided.
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