Miscellaneous Grant Application
The purpose of this grant is to provide financial assistance to individuals living with Spina Bifida. The grant is intended to be used for unique opportunities, adaptive or assisstive equipment, or other expenses related to Spina Bifida.

Awards will be paid on behalf of the applicant and not necessarily to the applicant.
Application Requirements:

• Grant applicant must have a Spina Bifida diagnosis. You may be asked to provide proof of diagnosis.
• Applicant must reside in West Michigan.
• By submitting this grant application, you agree to write and submit a few paragraphs describing how you used your grant, along with a photo. The WMSBO may print and distribute your photo and paragraph.
• Additional information may be requested.
Applicant Name *
If under 18, Parent or legal guardian
Email *
Phone *
Address *
Have you attended a WMSBO event in the past year? *
Please describe why a grant is needed and for what prupose the grant will be used.
Amount requested
Have you sought funding from other resources? *
If yes, what sources?
Date grant is needed
MM
/
DD
/
YYYY
Comments
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy