Joey Watson Conference Assistance

SUPPORT ORGANIZATION FOR TRISOMY 18,13 AND RELATED DISORDERS

JOEY WATSON MEMORIAL FUND APPLICATION

The Joey Watson fund was established to assist families who cannot fully afford to attend the conference.  It helps primarily by providing hotel and conference registration expense assistance.  Some transportation expense assistance might be available on occasion.   Applicants are expected to have requested assistance from local civic clubs, their preferred religious institution or other sources before applying to the Joey Watson fund.  This application form MUST BE RECEIVED AT SOFT HEADQUARTERS BY MAY 15th.  Donations to this fund are greatly appreciated.

I. QUALIFICATIONS OF THE APPLICANT ARE:

1. Must be a current member of SOFT.  You can check your registration status here.
2. Must be personally affected by or have a family member who is affected by a trisomy condition.
3. Application must be received by SOFT by the May 15th deadline, for review by designated SOFT committee members.
4. Must be attending the full SOFT conference.

II. PERSONAL INFORMATION

Name _____________________________________________

Address ____________________________________________

City, State, Zip _______________________________________

Phone Number (       )_________________

Name of person with disability____________________________

Primary Diagnosis _____________________________________

Date of Birth ________________________________________

Brief statement about the person with a disability

___________________________________________________

___________________________________________________

___________________________________________________

People and ages of family members attending conference:

___________________________________________________

___________________________________________________

Estimated Cost: Plane or car (gas only):

Hotel nights:

Registration fees:

Other:

Total:

List all resources attempted for financial support (ex. Lions, Rotary,

Knights of Columbus, State agencies, fundraising):

____________________________________________________

____________________________________________________

 Applied to Noah’s Never Ending Rainbow?

 Approved  Not Approved (for committee use only)

NEEDS STATEMENT:

Please write a brief summary about how support to attend a conference will enhance the quality of your family life and why you are a worthy recipient.

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Deadline: May 15.

Date submitted: __________________

Please return to: SOFT/VanHerreweghe
2982 South Union Street
Rochester, New York 14624

Email: barbsoft@rochester.rr.com
Fax: 585-594-1957

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