Grant Application: Cure MLD Families
Cure MLD provides travel grants for families seeking treatment in the US and abroad ($500 for local travel and $1000 per affected child for international travel). We also provide emergency grants for families in need. Grants are provided on a one-time basis and range from $500 or more based on the documented need. Such funds may not be used for home renovation projects.
Contact information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Grant
We want to know a little more about how we can help your family at this time. The more specific, the better.
Are you looking for financial assistance for:
Traveling to treatment
Financial emergency
Other
Amount that you are applying for:
Travel grants: $500 - $1000 (depending on domestic vs. international), Emergency grants: up to $2000
To get to treatment, are you traveling domestically (within your home country) or internationally (outside your home country)?
Domestically
Internationally
Other (please explain at the end)
Please upload documentation confirming the MLD diagnosis.
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Please upload documentation confirming the need for treatment for which you are traveling. (This might be a letter of support from a doctor, social worker, etc. explaining the need for treatment.)
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Please upload documentation showcasing financial need. (This could be any number of things including a letter from a bank, documentation of welfare assistance, etc.)
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(Optional) You may use this space to tell us more about you and your family and/or explain anything else you want us to know.
We want to hear how we might be able to assist you and your family!
Thank you for filling out our grant application.
We will get back to you as soon as possible. Please don't hesitate to email melanie@curemld.com with any questions.
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