Santa's Grant Application
The Sensational Santa program is excited to offer a grant opportunity for 2017! This year we will offering a weighted blanket, and two recipients will be selected.

Submissions for Santa's Grant are due by Wednesday, January 31, 2018 at 5pm. Preference will be given to families who have utilized the Sensational Santa program and/or are involved with the Exceptional Families Network’s various programs and services – www.exceptionalfamilies.org.

All information provided will be kept confidential. A committee will select the recipient(s). The Exceptional Families Network, via the Sensational Santa program, will then notify the recipient(s) via email no later than Wednesday, February 7, 2018.

The selected recipients will be able to pick up their weighted blanket at the EFN office in Lakewood.

Completed applications indicate the following: 1) your agreement to be added to the Exceptional Families Network mailing list, 2) your acceptance of the terms and conditions of the grant, and 3) your submitted information will act as an electronic signature.

If you have questions about the Santa's Grant program, please email Corinne Dutton, at exceptionalfamiliesnetwork@gmail.com.

Email address *
http://www.exceptionalfamilies.org
Section 1 - Contact Information
The following information is required and will help us contact you in the event that you are selected for the grant.
Parent/Guardian's First & Last Name *
Your answer
Email Address *
Your answer
Mailing Address *
Your answer
City, State & Zip Code *
Your answer
Primary Phone Number *
Your answer
Secondary Phone Number, if any
Your answer
Relationship of Person Completing Application to Child *
Child's First & Last Name *
Your answer
Child's Sex *
Child's Age *
Your answer
How have you participated with the Exceptional Families Network? *
Check any/all that apply. Preference is given to applicants who have participated with EFN.
Required
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