Campbell McLaurin Foundation (CMF) is a charitable organization and provides assistance with the funding for hearing aids, equipment and other hearing assistive devices, free of charge to the Applicants. Neither CMF nor its Trustees endorse any products, manufacturers or suppliers. CMF and its Trustees are not responsible for the correct manufacture, supply, use or operation of any hearing aid, equipment or other hearing assistive device nor the failure of such. Nor are CMF or its Trustees responsible for the misuse of any hearing aid, equipment or other hearing assistive device and any resulting damage therefrom.
Declaration of Applicant
I hereby make my application for financial assistance from the Campbell McLaurin Foundation; and I declare that:
a). Any assistance awarded will be used only for the intended purpose of the grant;
b). If my circumstances as outlined in this application should change during the granting process, I will notify the Campbell McLaurin Foundation;
c). I have truthfully and fully disclosed my financial situation to the best of my knowledge and give permission to the Campbell McLaurin Foundation to verify my circumstances;
d). I consent to the disclosure and release by the Campbell McLaurin Foundation of any information relevant to and required for the process of my application for assistance;
e). I give my expressed consent to be contacted via email by the Campbell McLaurin Foundation (If you do not wish to give your expressed consent for email correspondence, please let us know at firstname.lastname@example.org);
f). I make this declaration conscientiously believing it to be true, and of the same force and effect as if made under oath.