Speak 4 Me Foundation is providing a limited number of iPads to support communication, learning and accessibility for children with developmental or communication needs. This giveaway is currently offered to families in the San Fernando Valley, Sacramento and Kern County areas. Recipients will be selected based on the needs shared in this form. Please note that a limited number of iPads are available. Submissions will be accepted until December 16, 2025.
Name
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First Name
Last Name
Email
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example@example.com
Child's name
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First Name
Last Name
Child's Date of Birth
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Month
-
Day
Year
Date
Does your child currently have access to a tablet or communication device?
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Yes
No
Does your child have an IEP or disability related support needs?
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Yes
No
How would an iPad support your child’s communication, learning, or daily functioning, and what challenges does your family currently face in accessing a device?
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0/850
Share something about your child that makes you believe they would benefit from an iPad at this time.
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0/850
Optional: Upload any document that helps us understand your child's support need.
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If selected to receive an iPad, I agree to provide a photo of my child. I understand this photo will be used for winner announcements, donor reporting, and promotional purpose for Speak 4 Me Foundation.
Please Select
Yes, I agree and understand this requirement.
No, I am unable to agree at this time.
Optional: If you would like, you may upload your photo now.
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Disclaimer: Participation in this application process is voluntary. Submitting this form does not guarantee selection or the receipt of an iPad. All information provided will be used solely to review applications. Speak 4 Me Foundation reserves the right to verify information, limit or deny participation based on eligibility criteria, and modify or cancel the giveaway if needed. By completing this form, applicants acknowledge that selection is not guaranteed and is based on available resources and alignment with program goals. Information submitted must be accurate to the best of your knowledge. Speak 4 Me Foundation may contact applicants for clarification if needed. Personal information will remain confidential. Speak 4 Me Foundation is not liable for delays, cancellations, or unforeseen circumstances that impact the distribution of devices.
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I agree and understand.
I confirm that I live in the San Fernando Valley, Sacramento or Kern County area and understand this is a requirement for participation?
*
Please Select
Yes
I would like to receive updates, emails, and program information, and resources from Speak 4 Me Foundation.
Yes
No, not at this time.
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Please verify that you are human
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