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SOUTH CENTRAL KENTUCKY COUNCIL OF THE BLIND

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Serving the blind and low vision population of South Central Kentucky

Grant Application Form

South Central Kentucky Council of the Blind

With the submission of the SCKCB Grant Application Form, you are acknowledging that you have read the SCKCB Grant Guidelines and fully comply with and agree to the conditions set forth in those guidelines.

Grant applicants will be notified, in writing (either hard copy or electronically), of the decision within ten days following the Quarterly meeting of the Grant Oversight Committee in which the decision about your application is rendered.

An individual seeking matching funds is not eligible if they have already purchased the piece of equipment prior to or at the time of applying for a SCKCB Grant, i.e. any reimbursement for devices already purchased is not allowed.

Please answer the following questions (* indicates a required entry):
Name of grant beneficiary: (*)
Mailing Address:
Is the beneficiary of the requested grant legally blind? (*)
If the beneficiary is under the legal age of 21, Name of parent or guardian
If the beneficiary is under the legal age of 21, Address of parent or legal guardian:
Acceptable file types are PDF (.pdf) and Microsoft Word (.doc and .docx) files.
Acceptable file types are PDF (.pdf) and Microsoft Word (.doc and .docx) files