I AM's Wellness Grant Application

(January 1st, 2023-December 31st, 2023

  • MM slash DD slash YYYY
  • All funds will be mailed to the address as designated on the application with the check made payable to the provider, except in the case of reimbursement where a check will be sent to the individual after providing proof of expenses. Please provide the following information:

  • What is the cost for the service for which you are seeking support?

  • Note: Requests for up to 75% of costs in a calendar month will be considered with a total award amount not to exceed the maximum of $500.00. Eligible expenses include costs associated with activities that promote physical movement. These include memberships, user fees, personal training, as well as expenses related to the pursuit of sports such as equipment rental, lessons, and costs related to events in which the applicant participates. Also covered are holistic practices such as counseling, meditation training, nutrition counseling, massage therapy, and acupuncture. Excluded expenses include the purchase of equipment, any kind of physical or occupational therapy, or medical treatment. If you are unsure if expenses are eligible, please use the space provided to make the request and include justification.

  • Note: the following information will only be used for the purposes of program assessment and to describe program participants as a group. This information will have no bearing on grant awards. No individual information will be shared with outside entities.

  • Thank you for taking the time to fill out the application! We will review the information provided and get back to you regarding its approval status. Please feel free to contact us if you have any questions.

OUR SINCEREST THANKS TO OUR SPONSORS FOR SUPPORTING THE EFFORTS OF I AM!

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Champion

Discover, Develop, and Celebrate Abilities!