DSNGG Jack Pot Fund Application

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The Jack Pot Fund was created on May 28, 2011, in honor of Jack Hickling’s first birthday. The fund is intended to benefit families in the Down Syndrome Network of Greater Greensboro by assisting families who may be struggling to afford medical or therapy copays or expensive medical equipment their children need to thrive. Any family within the DSNGG may apply for a monetary gift from The Jack Pot Fund, and each application will be reviewed by our Board of Directors.

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E-pasta adrese *

First Name *

Last Name *

Address 1 *

Address 2 *

City *

State *

Zip Code *

Are you: *

a self-advocate

a relative of an individual with Down Syndrome