MISSOURI COUNCIL OF THE BLIND ADAPTIVE TECHNOLOGY GRANT PROGRAM GUIDELINES



MISSOURI COUNCIL OF THE BLIND
ADAPTIVE TECHNOLOGY GRANT PROGRAM GUIDELINES
Revised May 9, 2006


I. THE PURPOSE

The Missouri Council of the Blind desires to enrich the lives of legally blind Missourians and believes that an adaptive technology grants program can assist in fulfilling this desire.


The Council realizes the inability of many of the legally blind of Missouri to purchase such equipment, both because of the high cost of the equipment and because of other more pressing financial obligations.



II. APPLYING FOR A GRANT

A legally blind Missourian wishing to apply for an adaptive technology grant may do so by any of the following means:



III. MATCHING GRANTS



IV. HOW MAY GRANTS BE USED?

The applicant may submit a written appeal to the Board at its next regularly scheduled meeting. The Board will then vote to accept or deny the appeal. The Chair of the Committee will then notify the applicant of the result of the vote.



V. THE COMMITTEE





MISSOURI COUNCIL OF THE BLIND ADAPTIVE TECHNOLOGY GRANT APPLICATION










 

IF YES, WHAT EQUIPMENT WAS PURCHASED WITH THE GRANT?

 

 

DOCUMENTS NEEDED TO ACCOMPANY APPLICATION
Three copies of the completed official price quote on vendor's stationery.
A letter from an ophthalmologist or other reasonable authority giving specifics
about your eye condition, including visual acuity and field.


AGREEMENT
Should I receive a grant from the Missouri Council of the Blind for the purchase of
adaptive equipment but decide not to purchase all or part of the
equipment listed on this application, I agree to return to the Missouri Council the amount
of the grant applicable to the equipment not purchased.
I understand that I am to purchase only new equipment with this grant.


SIGNATURE: ____________________________________________________

Please forward this completed application and pertinent documents to the chairperson of
the Adaptive Technology Grant Program Committee:
Franklin Johnson
C/O MCB
5453 Chippewa
St. Louis, MO 63109
Phone: (314) 832-7172

Date approved: ___________________
Date denied: ____________________

Signature of chairperson:_______________________________________________________________


RELEASE OF INFORMATION FORM



*Applicant is to fill in the name, address and phone number of the appropriate agency,
organization, business or physician; sign and date the Release Form and enclose
it with the application.

This is to authorize:



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