2016Organization Grant Application Directions

The Different Needz Foundation is a 501(c)(3) charitable organization. The Foundation’s primary mission is to awardgrantsfor medical equipment, therapy devices, adaptive toys and/or services to individuals with developmental disabilities, their families and organizations that support them.

Note to Applicants: Grants are awarded at the sole discretion of the Different Needz Foundation Board of Directors. If your grant request is approved, the equipment provider or service provider will be paid directly by The Different Needz Foundation.

Grants to organizations who service people with developmental disabilities are limited to a maximum of $2,500.00. Organization grants will not be awarded for operational expenses, employee wages or general funding. The Foundation is not obligated to award an organizational grant in any given year.

Please read the following directions to help ensure that your application is filled out properly.

  1. Application must be typed.
  2. Applicants or applications that do not qualify for a grant will not be considered. Recipients must have a developmental disability as defined on our web site.
  1. Only type on one side of the application, do not use the back of any page.
  1. It is mandatory to include with your application, price quotes, catalog pages or other information that supports the amount you are seeking. Failure to fully provide this information willdisqualify your application.
  1. DO NOTstaple any of the pages.
  2. Mail via standard U.S. mail (certified mail or any other express carrier will not be accepted) completed application and supporting documentation to the Different Needz Foundation. Application must be postmarked by March 1, 2016. Application and supporting documentation can also be emailed to the Foundation. Emailed applications must be received by March 1, 2016 at 11:59 pm Eastern Standard Time.

7.The Foundation strongly discourages applications requesting motor vehicles and Apple iPads.

8.Do not include the instruction pages of this application, personal photos or any information not requested.

Please mail the application and supporting documentation to:

The Different Needz Foundation

8584 East Washington St. #122

Chagrin Falls, OH 44023

Application MUST be postmarked by March 1, 2016.

or

Application and supporting documentation can be emailed to the Foundation.

Email applications to:

Emailed applications must be received byMarch 1, 2016 at 11:59 pm Eastern Standard Time.

Notification of the Foundation’s determination will be sent to applicants via standard U.S. mail approximately eight to twelve weeks from the deadline. We may contact you for further information.

Thank you for your application.

The Different Needz Foundation

Questions? Contact the Different Needz Foundation at 216.904.5151 or email at . Go to for additional details.

2016 Different Needz Foundation Grant Application

Must be postmarked by March 1, 2016

Organization Name:

Contact Name:

Street Address:

City:

State and Zip Code:

Phone Number:

Email Address:

Item(s) Requested:

Cost of Item(s):

Have you applied

fora Different

Needzgrant before?YesNo

Please circle answer.

If yes, were you awarded

a grant, when and what

was the item?

2016 Grant Request

You must include supporting documentation as to the service or item and its cost. Failure to include supporting documentation will disqualify your application.

Please tell us about how your organization services individuals with developmental disabilities.If additional space is needed, please continue on a separate page. DO NOT USE THE BACK OF ANY PAGE.

Please tell us about your organization’s funding and your ability to obtain funding from other sources for the requested item. If additional space is needed, please continue on a separate page. DO NOT USE THE BACK OF ANY PAGE.

Please tell us about the service or item that you need. Please include a detailed description of the service or item, information about how it will benefit the individuals with developmental disabilities you service, the provider’s name, address and telephone number and the amount of the grant being requested. Proper documentation must be included with the Application. If additional space is needed, please continue on a separate page. DO NOT USE THE BACK OF ANY PAGE.

Applicant Signature: ______Title: ______

Date: ______