2017 Deadlines for ONE Grant:
Apply by: January 31           Notification: February 28
Apply by: April 31                Notification: May 31   
Apply by: July 31                 Notification: August 31  
Apply by: October 31          Notification: November 30

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.

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
Business Contact Person *
Business Contact Person
Business Address
Business Address
Business Phone Number *
Business 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: *