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Affinity Healing Collective 501(c)(3) Funding Application

This application is for funding requests to support therapy services for clients or to provide funding for therapists to cover training or respite.

If you experience any issues with the online application or additional materiels, send a direct message to info @ affinityhealingcollective.com.

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Affinity Healing Collective 501(c)(3) Funding Application - For Clients

Affinity Healing Collective 501(c)(3) Funding Application - For Clients

Section 1: Therapist Information

*This form is to be filled out by the therapist on behalf of the client.

Section 2: Client Funding Request

Client Information:

Funding Request Details

Additional Requirements:

 

Section 3: Client Demographic Information

Demographic information required for grant-funding purposes.

 

Section 4: Acknowledgment and Signature