Ivy and Roses Community Fund Scholarship Application 2017

Individual Grant Application

Serve the Spectrum Inc.
Serve the Spectrum Inc., founded in 2021, is a nonprofit supporting autistic individuals, the organizations that serve them, and schools with ASD students. Through our grants, we help the greater Charlotte community access essential resources, tools, and services.

Our Mission

Our mission is to expand access to resources and services for autistic individuals by providing financial support to families, organizations, and schools. We strive to help every person we serve reach their fullest potential.

Instructions for Application Submission

Applicants may fill out the below form to apply for a grant for financial assistance. The grant may be used to assist individuals on the autism spectrum with the cost of therapy, treatment, camps, activities, resources/tools, etc. that may improve the life and well-being of that individual with autism. We currenty serve the greater Charlotte area.

Applications must be submitted by May 1, by 11:59 PM.

Application Review and Award Timing

Applications will be reviewed during the month of May. If additional information is needed to process your application, we will contact you via email or phone at that time.

Awards are communicated during the month of June and distributed in the June/July timeframe.

Applicant Parent/Guardian Information
Full Name*

PrefixFirst NameLast Name
Relationship to Applicant*
i.e. Mother, Father, Foster Parent, Social Worker, etc.
Parent/ Guardian Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
E-mail*
Proof of ASD Diagnosis*

Upload a File
e.g: MD Formal Diagnosis, Psychological Eval, etc. Cancelof

Household Financial Information
Household Monthly Income*
*Monthly Gross Income
Household Proof of Income (IRS Form 1040)*

Upload a File
Most recent US Income Tax Return (IRS Form 1040) - Summary Pages Only Cancelof
Household Proof of Income (W-2 Form)*

Upload a File
Most recent W-2 Forms for the Household Cancelof

Financial Need
Description of the therapy, tuition, activities, and/or resources where financial assistance is being requested:*

0/250
Estimated Funding Requested*
*Awarded Grants are typically under $1,000
Has the applicant been awarded the NCSEAA Opportunity Scholarship?*
Has the applicant been awarded the NCSEAA ESA+ Scholarship?*
Has the applicant been awarded a grant from Serve the Spectrum previously?
List any additional scholarships/ grants the applicant has received this calendar year (include amounts).*
Type "n/a" if no other scholarships/grants have been received by the applicant
Addtional details you would like to share with us (optional)?
*Optional*

Signature and Disclaimer
Signature (Please type your name)*
I certify that my answers are true and complete to the best of my knowledge.
Date Completed*

MonthDayYear
Enter validation text*
Should be Empty: