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Grant Application

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 FormDownload 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.

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