Grant Application Form
The completion of this application does not guarantee a grant for therapy. All information will be kept confidential. If you are among the finalists, you will be contacted for an interview.
Applicants can apply for a grant two different ways:
Printed Form – Download the Application Form. Fax the completed form to 734-953-1743.
Online Form – Complete the Online Application below and click Submit. You will receive an email confirming your submission.