Clone of Heart of Variety 2025 Award Request Form

Heart of Variety Grant Request Form
Eligibility Check: Do you live in Texas and have a child, youth, or young adult age 22 or younger who lives with a disability in your household?
Primary Contact Name

First NameLast Name
Primary Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Primary Contact Email
example@example.com
Number of People in Household
Zip Code
County
Example: Travis, Tarrant, Harris, etc.
Alternate Contact Name

First NameLast Name
Alternate Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Contact Email
example@example.com

Follow-Up & Consent
How do you prefer we contact you for follow-up? (Most updates are sent by email newsletter. Please add hov@varietytexas.org and skyler.lightfoot@varietytexas.org to your contacts and check your spam folder. Your selection below will be used only for direct, individual communication.)
Would you be willing to share a note, photo, or video later about how this funding made a difference?
Do we have your permission to use your story or photo in reports to funders?
Would you like to sign up for our newsletter to receive notifications when rounds of funding open?

Heart of Variety Grant Request Form