Spina Bifida Association of Kentucky Grant Application

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1 Spina Bifida Association of Kentucky Grant Application

2 SBAK Grant Fund General Guidelines Through this application process, a designated committee will responsible for the approval or denial of the request. Monies are given for the direct benefit of the individual affected by Spina Bifida. Monies are never paid to an individual. Monies are paid directly to the chosen academic institution. Grants are awarded to first-time applicants first. If funds remain, continuation grants may be awarded. Each semester (Fall and Spring) only one applicant will be awarded a $1,000 grant. Application Deadlines (Applications mailed must be postmarked by the dates listed. Applications submitted electronically must be received by 5:00pm est. on the dates listed April 1 st for Fall Semester Applications September 1 st for Spring Semester Applications These dates are firm and any applications received after the dates listed will not be considered. In order to be considered, your application will have to be resubmitted again before the next date listed. No Exceptions. The information you provide may be used on SBAK website, SBAK Program link. Additionally, recipient may be requested to provide additional photos and other narrative. Grants do not require re-payment. Applicant must apply for any other recommended assistance (grants, loans, scholarships, etc). Student may only apply once a year not per semester. Must be a full time student. Incomplete applications will not be consider for review by the Selection Committee. Therefore, it is the applicant responsibility to verify all information and attachments have been provided by the deadline. All applications (selected and non-selected) will be notified by the Selection Committee within 30 days of the application deadline. Applicants need not be members of SBAK, however, the applicant should live in or near the Kentucky s service area. All monies granted will have the purpose that supports the Spina Bifida Association of Kentucky s mission. All monies granted will be in accordance with generally accepted accounting principles (GAAP) and will be audited in accordance with generally accepted auditing standards (GAAS) by an independent CPA.

3 Steps for Grant Request 1. Applicant fills out application. 2. Required Attachments: a. List of activities, clubs, hobbies, etc. b. 500 word essay on why you should receive this grant. c. Plans for future, field of study, career, etc. d. Spina Bifida: type e. Three letters of recommendation (only one can be from a relative) 3. Mail application and attached information to: Shriners Hospital for Children Spina Bifida Association of Kentucky 1900 Richmond Rd. Lexington, KY Send electronic applications with attached information to egillespie@sbak.org or sbak@sbak.org. 5. Applicants are required to attach verification of acceptance to the program/educational facility before funds are awarded. 6. Applicant must maintain at least a C average or future funding will NOT be considered. 7. SBAK staff may contact you if additional information is needed. 8. Application is presented to the Committee. 9. Committee reviews. 10. Designated Staff (On-Call Consultant) contacts family or individual. 11. If funds are approved, SBAK pays school directly.

4 APPLICATION SBAK Grant Application Date Name of individual DOB Address City State Telephone: Home: Cell: Best Time to Call: Additional Contact Person (if we cannot reach you): Phone # Are you and active SBAK participant Yes No If yes, what programs or event have you attended in the past 2 years? How did you hear about the SBAK Grant? If approved, this grant will benefit you how? (please be specific) Are you receiving any other assistance with tuition (i.e. other grants or scholarships)?

5 No Yes If Yes, please explain Have you applied for all other assistance available to you? No Yes If Yes, please explain and include outcomes of each request. Education: High School (include City, State) Post-Secondary Institute you to attend (include City, State) Other information that you wish to share with the committee. Funds available are limited. I understand that the decision of the committee is final. Signature of Individual Date Information provided on this application form is confidential. The written permission of the adult applicant or the parent/guardian of a child applicant is required for information to be shared with another agency, professional or provider. Applications will be retained by SBAK for two years.

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