Grant Application

    Call (313) 744-3488 for questions or help with this form.

    Contact Information

    Contact Preferences

    Purpose of Item being requested

    Item Description

    Below, please provide a description of the item you will be purchasing. The reason for the item and how it will increase your independence. The cost, place of purchase, and include a link to the item if possible. Someone from the committee will contact you within 30 days. Thank you.