Grant application

TrackStart.jpg

START foundation’s Grant Program.

START foundation raises funds to support a grant program to assist amputees to purchase a sporting prosthetic limb (s), limb device or have sporting equipment modified. The intent of the grant program is to assist amputees to achieve their sporting dreams. To be considered for a START foundation grant, applicants must:
• Demonstrate proof of Australian citizenship
• Provide an itemised quote from an eligible supplier for the desired prosthetic limb, limb device or equipment modification. Note: START foundation will review and verify quote and supplier. If you are unable to provide a quote, START foundation may recommend a supplier
• Provide two references from a coach, mentor, teacher or employer
• Provide a medical certificate verifying amputation, limb impairment or limb difference
• Outline details of current prosthesist or equipment manufacturer that is presently providing support (if any)
•If shortlisted for a grant, participate in an interview – face to face or via video-con (skype)
•If successful in being selected for a grant, accept all terms and conditions of the contract.

NOTE:

1. Where applicants are eligible for government funding toward some components of a prosthetic prescription, a START foundation grant will cover part of or the outstanding ‘gap’ payment.
2. START Foundation will store information contained in the grant application in accordance with the START foundation Privacy Policy on the website.
3. Grants will NOT be awarded for a retrospective purchase of a prosthetic limb, limb device or equipment modification.
4. Grant payments are made directly to the third party provider of the prosthetic limb, limb device or equipment modification.

All applicants must complete Part A and Part B

Grant Application Form. (Part A)

Name *
Name
Date of birth *
Date of birth
If Applicant is under 18 years of age.
Address *
Address
Phone / mobile *
Phone / mobile
Eg: birth, post accident, consequence of medical condition?
 

Grant Application Attachments. (Part B)

Use the email button below to attach the following information:

1. A Personal Biography to include the following:
• A personal introduction outlining your background and your sporting dream.
• An explanation of how you plan to achieve your sporting dream, including timeline.
• An outline of the challenges you face in achieving your dream.
• How a grant from START foundation will assist you?
• Why START foundation should support your application?

2. Two references from a coach, mentor, teacher or employer.

3. A Medical Certificate - proof of amputation, limb impairment or limb difference.

4. Provide an itemised quote for the cost of prosthetic limb/s, limb device or equipment modification, identifying components likely to be covered by government funding.

5. Proof of Australian citizenship (copy of birth certificate, passport or citizenship papers)

6. Signed statement of consent from parent or guardian if under the age of 18 years

When you have completed your application, along with all required attachments START Foundation will:
• Confirm receipt of your application.
• Contact you if further information is required.
• Advise you of the outcome of your application.