Apply for a Mini-Grant

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Virginia Del Sordo Fund

Apply for a mini-grant in memory of Virginia Del Sordo.
Let's see if you qualify for this mini-grant. Check all that apply.*

I live in Pennsylvania.I have a gross income of 400% of the federal poverty level or less.I have no other way to completely pay for the tools or technology I need.I know what I need because I have used other TechOWL programs such as the Lending Library or a professional recommended this particular tool/technology.
Applicant Information
Full Name*

First NameLast Name
Address*

Street Address

Street Address (continued)

CityState

Zip Code
County of above address*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Date of Birth*

MonthDayYear
This person's gross annual income.
Include social security or pension but do NOT include other family members or household income.
Number of total members in the family or household including this person.
Please describe the applicant's disability or challenge.*
Please tell us what you need to purchase. Include name, model, maker and cost.*
Is the tool/technology made specially for a person with a disability? *
Please explain how the tool or technology will help the person improve or keep functional skills.
How will this mini-grant be used to get the tools and technology you need?*
This tool/technology will be used mostly at...*

home/community.school.work.
How did you select this particular tool/technology?

I borrowed it from TechOWL's Lending Library.I borrowed it from somewhere else.A professional showed it to me. (not a salesperson)A professional recommended it to me.
Name & Title of Professional
Organization of Professional
Describe the ways you have tried to get this tool/technology paid for and not been successful.*
Alternate Contact

(if necessary)
Name of Alternate Contact

First NameLast Name
Phone number of Alternate Contact

Area CodePhone Number
Email of Alternate Contact
example@example.com
Relationship of Alternate Contact
What is the relationship with the applicant
We need these documents.

If you have trouble uploading documents, please call us at 800-204-7428.
This program requires proof of income. *

Upload file(s)
Submit by uploading ONE of the following: Section 8, SNAP, LIHEAP, MA/ACCESS, National School Lunch Program, SSI, or other proof of income. Cancelof
This program requires proof of residence. *

Upload file
Submit by uploading anything pre-printed with the applicant's name and current street address. Cancelof
Race / Ethnicity (optional)

Caucasian / WhiteAfrican- AmericanAsianLatinoPrefer not to answer
Gender (optional)

FemaleMalePrefer not to answer
How did you hear about us?*
Please type your name.
This is your signature.
Date and Time Submitted
If you are selected to receive funding, TechOWL would like to use your story to promote this program. Therefore, we would like to know if you would share your story and allow us to photograph you for promotional/educational purposes. Your agreement is purely voluntary and will not affect your eligibility for funding.
Should be Empty:

Virginia Del Sordo Fund

Applicant Information

Alternate Contact

We need these documents.