Member Financial Assistance
Member Financial Assistance Application
Please read the Financial Assistance Guidelines thoroughly before completing this application.
- Every question must be answered for the application to be complete.
- Applications are accepted any time but are only reviewed in the months of January, May, and September. Decisions are sent to applicants no later than the final day of the review month. Applications received after the first (1st) of January, May, or September will be held until the next scholarship period.
- If applying for multiple invoices from different services, please submit separate applications for each program. (i.e. if you are applying for money to reimburse a doctor’s visit copay and money toward tutoring, this would require two separate applications)
- If applying for adoption assistance, please use the Adoption Assistance Application.
The Down Syndrome Association of West Michigan has established a Member Financial Assistance Fund to help DSAWM members meet financial obligations for their children with Down syndrome. Scholarships are available for the following categories:
- Medical and therapeutic services such as doctor appointments, surgeries, medical procedures, speech therapy, occupational therapy
- Equipment or devices such as gait trainers, orthotic devices, AAC devices, glasses, hearing aids
- Programs such as therapeutic or educational services, tutoring, hippotherapy, etc.
Payment will be made in the form of reimbursement to the member after proof of payment has been shown. In some cases, DSAWM may pay a medical or therapy provider directly with proof of a current invoice. Reimbursement amount is at the discretion of the DSAWM Financial Assistance Committee and will not exceed $500 per member per calendar year. Preference will be given to members who have not previously received financial assistance. Reimbursement is available for financial obligations to be met in the current year ONLY. Please contact our office at 616-956-3488 with questions regarding these requirements.
To qualify for funding, an applicant must meet the following requirements:
- Live in the DSAWM service area
- Be a current year voting member
Applications will be reviewed tri-annually and ranked in order of highest need. Preference will be given to services & equipment prescribed by a medical provider. Should additional funds be available, the committee will consider applications for elective programs such as camps.
Please complete and submit the form below to apply. If you have questions, contact us at 616-956-3488 or email@example.com.
Applications can also be submitted through the mail to:
Attn: Financial Assistance Committee
160 68th St. SW, Suite 110
Grand Rapids, MI 49548