Mary 'Mermaid' McKillop Fund

Please complete the following on-line form if this is your first application for a three-month access pass to Seattle Public Swimming Pools or any public/private Swimming Pools.

DIAGNOSIS FORM REMINDER: 

A Diagnosis Form must be completed by your physician to confirm your diagnosis as a neurological disorder. Please download the Diagnosis Form here and mail it to us before the deadline for your application to be considered complete. The Occasions Grant is designed for opportunities of less than $1,000 and remember you can reapply in three months. 

Please complete the following online form if this is your first grant application or if you are applying for services from a new service provider.

 
Name *
Name
Address *
Address
Phone Number *
Phone Number
Do you have the financial means to pay for this experience? *
Is the applicant over the age of 18 years old? *
Please check all that apply: *