Special Services Application

Special Services Program

The MCB Special Services Program provides emergency financial assistance to blind and visually impaired Missourians facing unexpected crisis — medical emergencies, equipment repair, essential household needs, and more.

100%

Coverage for MCB members

50%

Coverage for non-members

Contact: Melvin Smith — moblind@moblind.org — (314) 832-7172

Special Services Program Details

Required field

Personal Information

First Name

Last Name

Phone

Mailing Address

Address Line 1

Address Line 2

City

State

ZIP

Eligibility Information

Visual Status

Are you an MCB member?

Yes

Household Size

Financial Need

Amount Requested

Describe Your Need

Income Sources

Why are you unable to pay for this need?

Other Attempts to Obtain Assistance

Download a Form

Printable PDF (PDF, 33 KB)Word Document (Word, 47 KB)

Fill in the Word document on your computer and email it to aa@moblind.org.

Mail to:

Missouri Council of the Blind
5453 Chippewa Street
St. Louis, MO 63109

Program Contact

Melvin Smith

moblind@moblind.org

Need Urgent Help?

(314) 832-7172

(800) 342-5632

moblind@moblind.org