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Financial Assistance Scholarship

Financial Assistance Scholarship Application

Please read the Financial Assistance Scholarship 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 Scholarship application.
Assistance review schedule graphic

The Down Syndrome Association of West Michigan has established a Financial Assistance Scholarship 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 Scholarship 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 info@dsawm.org.

Applications can also be submitted through the mail to:
DSAWM
Attn: Scholarship Committee
160 68th St. SW, Suite 110
Grand Rapids, MI 49548

Financial Assistance Scholarship Application

Applicant Information

Member's Name(Required)
Parent/Guardian's Name(Required)
Address(Required)

General

Has applicant applied for a DSAWM scholarship in the past?(Required)
If yes, has applicant received a DSAWM scholarship in the past?(Required)
Are you a current dues-paying DSAWM member?(Required)

Financial Aid Request

Not to exceed $500.
Please enter a number less than or equal to 500.
How should the request be paid out?(Required)
Which of the following best describes your request?(Required)
Check one (1) only.
i.e. What is the program/service? Why does your child need this service? What is the financial impact to your family?
i.e. "Due to low tone, my child has a speech delay. In speech therapy, he is working on forming the 's' and 'ch' sounds." or "Camp Roger provides additional staff for children with cognitive impairments and behavioral challenges."
Will insurance cover any portion of the costs associated with this request?(Required)
What medical coverage does the applicant have?(Required)
Check all that apply.

Additional Information

A minimum of one of the following is required. Please mark which type of document(s) you are attaching.(Required)
Drop files here or
Max. file size: 50 MB.

    Agreement & Signature

    This application was completed by(Required)
    I certify that my answers are true and complete to the best of my knowledge. If a scholarship is awarded, I agree to use the funds for the need specified in the application. Additionally, within 1 year of receiving funds, I will provide a statement of impact to DSAWM expressing how the funds impacted the applicant.(Required)
    Date(Required)
    This field is for validation purposes and should be left unchanged.
    Download Application
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    Address

    160 68th St. SW, Ste. 110
    Grand Rapids, MI 49548
    Located inside the Special Olympics Michigan Unified Sports & Inclusion Center

    Phone

    616-956-3488

    Hours

    Monday – Thursday | 9:00am – 5:00pm

    DSAWM is a proud member of the Global Down Syndrome Foundation, an organization dedicated to significantly improving the lives of people with Down syndrome through Research, Medical Care, Education, and Advocacy.
    DSAWM is a proud member of the Global Down Syndrome Foundation, an organization dedicated to significantly improving the lives of people with Down syndrome through Research, Medical Care, Education, and Advocacy.
    DSAWM is a member of Down Syndrome Affiliates in Action, an association of local, state, and regional Down syndrome organizations who share experiences, exchange program materials, and find ways to learn from each other.
    DSAWM is a member of Down Syndrome Affiliates in Action, an association of local, state, and regional Down syndrome organizations who share experiences, exchange program materials, and find ways to learn from each other.

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