Special needs children support, disabled children resources NZ

DOWNLOAD AND PRINT A PDF VERSION OF THE INDIVIDUAL GRANT APPLICATION HERE

Discretionary Grant Application Form
The purpose of a Grant is to support an initiative, activity or equipment that will enhance the life of children or young people who have a condition that affects their physical abilities. They must be under 22 years and live in the northern half of the North Island.

Applications will be considered four times a year. (Urgent applications may be considered – please speak to a Coordinator prior to submitting an application.) Closing dates for applications are as follows:

20 February 20 May 20 August 20 November

In all cases we would like to talk with you, so please contact us. Sally (09) 4853462 or 021 222 9964, sally@wilsonhometrust.org.nz or Anne (09) 4853463 anne@wilsonhometrust.org.nz

The Trust anticipates that families will have accessed support through Government agencies in the first instance.

Please note, if applying for equipment or modifications, we strongly urge that;

The equipment or modifications are in accordance with the advice of a suitably qualified and/or experienced professional.
There are reasonable grounds for believing that the child will be able to operate the equipment or make use of any modifications safely.
The usual safety advice is given around operating the equipment or modifications.
The parents or carers understand that the decision to allow the child to use the equipment rests with them.

By completing and forwarding this application, the applicant accepts full responsibility for the safe use of any equipment or modifications.

Your details:
First name:
Surname:
Email address:
Phone number: *
Mobile/ fax:
Street Address: *
Suburb: *
City: *
Postcode: *
Your relationship to the child e.g. parent or primary carer:
Childs details (if appropriate):
Child's first name:
Child's surname:
Residential Address:
Childs date of birth:
Has the child received funding from the Wilson Home Trust before? :
Are you applying elsewhere for funding?
What is the equipment, activity or assistance required?
How will this equipment, activity or assistance help the child/family?
Please include any other relevant information or comments.:
Amount Requested (including GST):
Please attach or email any quote/s for any items or services requested and include a supporting letter from a relevant professional.: Browse your hard drive to find the file to attach, then when the form is submitted, your file will be attached.