Parent Next Steps: Apply for Adaptive & Assistive Equipment - Special Education Foundation of St. Louis

Introduction

Through a grant from the Tilles Foundation, Special Education Foundation is able to support Special School District students by purchasing adaptive equipment that allows social interactions and builds confidence for those who are physically challenged. The grant provides funds for not only augmentative communication equipment/devices, but also computer and adaptive equipment that support independence. Funds from the grant open the doors for student success and increase opportunities for independence. Funds are limited.

Submitting this application does not guarantee approval.

Approval will be determined by committee after all information has been received.

SEF will inform teacher and parent/guardian(s) of decision via email and/or letter.

If request is approved, SEF will order the equipment. Please allow at least 3 to 4 weeks for delivery, once application has been approved and equipment ordered. Equipment will be delivered to the SEF office for processing. Your child's SSD teacher will be notified after equipment has been processed.

Questions? Contact SEF at 314-394-7030 or email info@sef-stl.org

ALL APPLICATIONS MUST BE SUBMITTED ONLINE

Applicant's Name*

First Last

School Attending*

District*

Grade Level*

Parent/Legal Guardian(s) Name*

Home Address*

Street Address Address Line 2 City State ZIP Code

Parent/Guardian(s) Email*

Home Phone*

Parent/Guardian(s) Cell Phone

Upload a copy of pages 1 and 2 from your most recent 1040 tax form.*

Accepted file types: pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, jpg, jpeg, png, gif, Max. file size: 20 MB.

IMPORTANT! Make sure to remove sensitive information not related to your financial status from submitted documents.

Statement of Financial Need

Parent/Guardian Release for Adaptive Equipment

To qualify for adaptive equipment assistance the student’s parents/guardians must be willing to talk with representatives from the Special Education Foundation and/or the Tilles Foundation.

We ask that you complete the questions below then sign. This form describes ways in which the Special Education Foundation may share information and photographs of students involved in Foundation activities and efforts.

I am willing to share the experience of the student/family who benefit from the Foundation's assistance and to inform those who might be interested in Foundation programs.*

Yes
No

I give my permission for the Special Education Foundation and the news media to photograph, tape record or videotape my child or myself and to use this photograph, voice or voice recording in publications, slides, videotapes, motion pictures, newsletters, newspapers, education websites, the Special Education Foundation website and news websites. I understand that the resulting photographs, stills, slides, videotapes, motion pictures, and audiotapes may be published for the purpose of instruction or informing students, parents, educators and the general public about the Special Education Foundation and its programs.*

Yes
No

I give my permission for the Special Education Foundation and the news media to use my child’s name and biographical information in stories involving the Special Education Foundation. I understand that this information may be used in publications, television or radio broadcasts, newsletters, newspapers, education websites and news websites for the purpose of instruction or informing students, parents, educators and the general public about the Special Education Foundation.*

Yes
No

By signing, I acknowledge that I, the parent/guardian, have personally submitted this form.*