Download - "Jacks Dollars" Scholarship Application
Download - "Jacks Dollars" Scholarship Peer Partner Application
Download - "Jacks Dollars" Scholarship Checklist
JACK'S PLACE FOR AUTISM FOUNDATION
Jack’s Place for Autism Foundation is dedicated to providing support, education, compassion and a comprehensive array of services to help families cope with the everyday challenges of autism.
Jack’s Place for Autism Foundation has created “Jack’s Dollars”, a Scholarship Program to help families afford the support they need for a variety of programs. Jack’s Dollar’s Scholarships will be awarded based on the following criteria:
· “Jack’s Dollars” available for the following types of programs:
o Recreation, Sports
· The individual to benefit from the program must have a primary diagnosis of autism spectrum disorder
· Families must reside in Michigan
· Preference will be given to first time applicants of “Jack's Dollars” scholarships. Applications reviewed periodically, no less than quarterly.
· Jack’s Place for Autism Foundation awards scholarships at its sole discretion
· Completed applications (“Jack’s Dollars & Program/Camp for which you are requesting funds) must be received at least 3 weeks prior to the program start date. Requests will not be considered if received prior to 8 weeks of camp or program start date
· Provider of program or camp (organization, institution, foundation, school, etc.) must be licensed and insured
· Applicants must provide Jack’s Place for Autism Foundation verification of diagnosis from treating physician/s or current IEP (Individualized Education Plan) or PCP (Person Centered Plan)
· Sibling or peer partner may apply for compliment program, where sibling or peer partner supports or assists individual with Autism Spectrum Disorder at program/or camp (peer partner must be enrolled in the same program/camp)
· Individual may apply for scholarship funds up to a maximum of $250 per calendar year per individual. Calendar year is January 1st to December 31st. Note: Excluded fees: Registration, enrollment or assessment.
· Please take note of our payment options 1 or 2 (on application)
· Please note that there is no age restriction for applicant. Our goal is to serve all individuals with Autism Spectrum Disorder
· Jack’s Place for Autism Foundation reserves the right to contact program providers
· Individual must disclose the amount of scholarship money requested from the program provider of which you have enrolled your child, please indicate on application. Failure to do so can result in denial of future funding
· Upon completion of program, applicant will receive a survey. Response is required within 60 days of receipt of survey. Failure to follow up may result in removal from future eligibility
· If program is cancelled for any reason-Jack’s Place for Autism Foundation expects that due diligence will be applied and any monies refunded will be returned to Jack’s Place for Autism Foundation
· If for any reason individual begins program and does not complete program, please notify Jack’s Place for Autism Foundation immediately in order to be considered for future funding
On behalf of Jack’s Place for Autism Foundation thank you for your application
for “Jack’sDollars”. We look forward to your survey with comments
regarding your program experience.
Mail Application to: Jack's Place for Autism Foundation
17360 W. 12 Mile Road, Suite 204
Southfield, MI 48076