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Kiddo's Clubhouse Foundation
Attn: Scholarship Application Team | |
11539 Park Woods Circle | |
Suite 502 | |
Alpharetta | |
GA | |
30005 | |
678-527-3224 | |
foundation@kiddosclubhouse.com | |
https://tinyurl.com/ycxdep93 |
Age Groups Served (please check all that apply:) | |
Infants and Toddlers (birth - 2 years) | |
Pre-school | |
Working | |
All Ages | |
Other Ages (specify): must be under age 21 |
|
Geographic Areas Served: | |
Coastal Georgia | |
Middle Georgia | |
North Georgia / Atlanta | |
South Georgia | |
Statewide - all of Georgia | |
National | |
Other Geographic Details (specify): |
|
Serves People with the Following Disabilities (please check all that apply): | |
Communication limitations | |
Learning limitations | |
Motor limitations | |
Personal care limitations (dressing, toileting, eating, etc.) | |
Sensory limitations (vision, hearning) | |
Other Demographics (specify): 0 |
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Financial Eligibility (please check all that apply): | |
Source will pay for some portion of AT devices / services | |
Scholarships available | |
Source accepts private insurance | |
Source accepts Medicaid | |
Source accepts Medicare | |
Other Financial Eligibility details (specify): |
|
Does the organization provide AT services? | |
Information about vendors / devices | |
Device demonstration | |
Help choosing right device / system | |
Help using current device appropriately | |
Device training | |
Fabricates special devices or adaptations | |
Repairs devices | |
Loans devices | |
Device rental | |
Financial help for device purchase | |
Help with insurance, Medicaid, or Medicare claim appeals | |
Technical assistance | |
Service coordination | |
Program advocacy | |
AT workshops | |
Other AT Services (specify) : |
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Does the organization provide AT Funding? | |
If yes, please indicate what services are provided; check all that apply) | |
Source sells devices | |
Source leases devices | |
Source loans device or money | |
Source gives device free of charge | |
Source pays for at least part of device cost | |
Other Funding Details (specify): |
|
Please indicate what types of AT devices the organization provides or provides services for: (check all that apply) | |
Adapted toys | |
Communication | |
Computer access | |
Daily living devices | |
Educational aids | |
Environmental units | |
Hearing aids | |
Home modifications | |
Job Accommodations | |
Medical devices / supplies | |
Prosthetics / orthotics | |
Recreational aids | |
Seating / positioning | |
Vehicle modifications | |
Vision aids | |
Wheeled mobility | |
All AT devices | |
Comments (any other information you would like us to include about your organization): | |
Scholarships awarded up to $2500 for payment of therapeutic services or equipment payable directly to the clinic where your child has received services licensed therapist or business of the equipment vending company that supplies the equipment. Application online. | |