ONLINE APPLICATION LOCATED AT THE BOTTOM OF THIS PAGE
Before completing the application please review the following information:
APPLICATIONS MUST BE SUBMITTED BY AUGUST 31, 2018.
For more information please email firstname.lastname@example.org or call 909-558-6384.
2018 GRANT & SCHOLARSHIP APPLICATION
Hello member of PossAbilities! We are pleased that you have decided to apply for assistance through our grant and scholarship program. The purpose of a PossAbilities grant or scholarship is to provide support for our members to improve the quality of life, assist in the reintegration of those with disabilities into the community and society, and to meet the specific needs of our members.
This application is designed to help determine your eligibility for a grant or scholarship, to provide a way for you to apply for an award, and to provide information as to how awards are granted. Please work through the application and follow all instructions. Your application must be complete to be considered. Use the Checklist worksheet at the bottom of this page.
|What type of funding is available?|
|Funding can be awarded to members for the following:
· Equipment to improve quality of life
· Accessibility grants (Not to exceed $15,000)
· Educational scholarships
· Social outings
· Travel to and/or participation in sporting events
· Other needs specific to the disabled population
MANDATORY ATTENDANCE AT THE CELEBRATION DINNER IN SAN BERNARDINO ON 12/2/18 IS REQUIRED.
|Who can apply?|
|Any member or support member of PossAbilities may apply based on the guidelines listed below. A friend or family member may also apply on behalf of a PossAbilities member, as long as the PossAbilities member is willing to sign a release of liability if selected to receive support.
· Members: A PossAbilities member is anyone with a disability who submits an application for membership and is enrolled in the program. Members are entitled to full benefits and are eligible to apply for grants and scholarships in support of needs they are not able to meet otherwise. Requests for funds to be used as supplemental income or to pay for medical care can not be provided by PossAbilities.
· Support Members: PossAbilities support members are able-bodied peers of the program and are only eligible for grants if they represent the PossAbilities program at sporting events. Grants and scholarships for support members may amount to but do not typically exceed $500 for support towards a requested activity. Support member requests above $500 will be assessed and determined by a committee.
|How are awards granted?|
|Awards are distributed directly to an organization, school, or company providing the resource for the PossAbilities member. PossAbilities does not give money directly to any individual. Awards are determined based on the applicant’s level of involvement in the program, longevity of membership, need, and potential impact on the applicant’s life.|
GRANT & SCHOLARSHIP APPLICATION (continued)
|When can I apply?|
|Applications may be submitted to PossAbilities from June 1st through August 31st. An application that is mailed must be postmarked by August 31st. An application that is emailed must be received by 11:59 pm on August 31st. The application is available for submission or download at www.teampossabilities.org.
If you have a pressing need that is deemed necessary for review outside of the June to August application period, you can request special consideration by the committee by completing an Off Cycle Special Request. NOTE: Requests of this nature must meet certain eligibility criteria and are subject to the decision of the review panel. Contact the PossAbilities at (909) 558-6384 to obtain this form.
|How do I submit an application?|
|You may submit your completed application in one of the following ways:
1. Via mail to:
LLU Health PossAbilities
25455 Barton Road, Suite 109A
Loma Linda, CA 92354
Attn: Christina Nieto
2. Via email to email@example.com
3. Via online application below
4. Hand delivery – must be delivered directly to a staff member in-person
|What happens after I submit the application?|
|Once your completed application is submitted, you will be notified in writing that your application was received. You will be notified of an award or denial no later than November 30th.|
|A review panel consisting of PossAbilities staff and members of the community will review, vote, and decide on awards for applicants. It is the intention and purpose of PossAbilities to thoughtfully consider all applications. While all needs are relevant, the quantity and amount of the awards are dependent upon available funds.|
|Can I apply more than once?|
|Due to the number of requests and the diversity of the needs of our members, you may only submit one application per calendar year. Past recipients of funding are not eligible to be considered for a PossAbilities grant or scholarship for two years from when they received funding. Applicants awarded an accessibility grant must wait three years. This ensures that PossAbilities is able to assist as many members as possible.|
|When will I know if I have been selected to receive a grant or scholarship?|
|After the August 31st deadline, the review panel has up to 90 days to select recipients. It is the intention of the panel to work as quickly as possible. You will be notified no later than November 30th.|
ARE YOU ELIGIBLE?
|Are you a member of PossAbilities?|
STOP! Only members are eligible to apply for a grant or scholarship. If you selected NO, please contact the PossAbilities office regarding membership.
|Do you have a disability?|
|YES NO If you selected NO, contact the PossAbilities office.|
|Can you confirm that your need is not for support to pay medical or personal bills and/or expenses?|
STOP! If you answered NO to this question, please contact the PossAbilities office for support. A grant or scholarship cannot provide for basic and/or personal expenses.
|Does your request fall into one of the categories listed below?|
– Equipment grant – Accessibility grant
– Travel to and/or participation in a sporting event – Athletic grant
|Are you an active member of PossAbilities?|
STOP! If you answered NO to this question, you are not eligible for a grant or scholarship. Funding is limited and only active members qualify for a grant or scholarship. .
|You are required to attend the PossAbilities Annual Celebration Dinner taking place on December 2, 2017 from 6:00pm to 8:30pm in San Bernardino, CA. Are you able to attend?|
STOP! If you answered NO to this question, you are not eligible for a grant or scholarship. Please contact the PossAbilities office if you have any questions.
If you answered YES to ALL of the questions above, you are eligible to complete the following Application.
If you answered NO to ANY of the questions above, please stop here and contact the PossAbilities office at 909-558-6384 for assistance.
REQUIRED SUPPORTING DOCUMENTS
Supporting Document #1: INVOICE FOR EXPENSES
|All applicants are required to submit verification that the amount they are requesting is an appropriate expense for the product or service they are requesting funding for. PROPOSALS OR ESTIMATES WILL NOT BE ACCEPTED IN LIEU OF AN INVOICE.
For equipment, construction services, or purchases from a vendor:
Attach an invoice from the company or business that will provide equipment or services.
Attach an invoice for the cost of tuition and/or estimated book expenses from the school.
Attach the brochure or print-out of the cost to attend or participate in the event or outing.
SEE BELOW FOR MORE INFORMATION ABOUT EDUCATIONAL SCHOLARSHIPS AND ADAPTABILITY GRANTS.
Supporting Document #2: COMPLETED W-9
|A W-9 must be completed by the vendor, company, business, or school that will provide the item requested in the grant.|
Supporting Document #3: Reference Letter
|**REQUIRED if request is more than $1,000***
Applicants are required to submit a reference letter for requests that are more than $1,000. Reference letters can be provided by anyone who knows you. Friends and family members can write a recommendation, but an employer, teacher, or community member who is not a friend or family member is preferred.
A letter of recommendation must contain the following information:
· Explain your disability and understand your need
· How a grant or scholarship would improve your quality of life
· Make a case that your request is appropriate and that you qualify for a grant or scholarship
· Give their assessment of your character and your ability to responsibly manage any award that is given to you
A maximum of 2 letters is allowed per application.
***NOT REQUIRED if request is less than $1000***
Supporting Documents #4: Biography & photo
|All applicants are required to submit a one page personal biography describing your disability, how it was attained (if applicable), your current activities and future goals. You must also email a personal high resolution digital photo along with your application (preferably related to your grant request) firstname.lastname@example.org. Your application will be considered incomplete until a high resolution photo has been submitted.|
REQUIRED SUPPORTING DOCUMENTS (continued)
Are you applying for an educational scholarship?
|If you are applying for an educational scholarship you must submit the following documentation with your application:
A completed and signed W-9 from the school. The school (registrar’s office, financial aid, or student accounts office) needs to provide a document on school letterhead that provides the student’s name, student I.D., and the payable information that provides where the scholarship check will be mailed to.
Proof of which course(s) (including course description) or book(s) the grant will be used for. This can be printed from the school website or school catalog.
Are you applying for an adaptability grant?
|If you are applying for an adaptability grant that includes home modifications, you must submit the following documentation with your application:
Proof of home ownership. Applicant or applicant’s parents must own the residence that will be undergoing modifications.
Proof of current contractor’s license. Selected contractor must be licensed in their respective state.
A completed and signed W-9 from the contractor.
The invoice from the contractor must contain the following items:
a. Contractor’s business name, address, phone, and email.
b. Tax I.D. or social security number.
c. Reference to the grant recipient (i.e. Accessibility grant for Jane Doe)
d. Billable to:
e. Invoice will bill for 50% to start the job and 50% upon completion.
f. Must include the following statement: Any expense that exceeds the $15,000 provided by this grant is the responsibility of the homeowner.
Upon completion of the modifications, photos will need to be provided along with an impact statement from the grant applicant.
NOTE: Your application will be considered incomplete if any required documentation is missing. Incomplete applications will not be considered for an award.
|Your application is ready to submit once you have….|
|Answered YES to ALL questions on Are You Eligible? (pg. 3)|
|Attached your Supporting Documents including your invoice, W-9, letter of reference (if applicable), 1 page biography, and digital photo (pg. 4 & 5)
Completed and signed the Application (pgs. 6, 7 & 8)
|Signed the Release of Liability forms (pg. 9 & 10)|
You are important to our program! We look forward to making a difference in the lives of our members.
COMPLETE GRANTS & SCHOLARSHIPS APPLICATION BELOW
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