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Edward Scott Zdenek Enrichment Fund Application Form
Applying for a CRDSS Enrichment Fund award is easy! Recipients can be anyone living in the CRDSS Central Pennsylvania region who has Down syndrome.
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* Indicates required question
Email
*
Your email
Name of individual completing the application
*
Your answer
Mailing Address
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Your answer
City
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Your answer
State
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Your answer
Zip
*
Your answer
Phone (Please indicate: Home / Work / Mobile)
*
Your answer
Recipient of the funds. This refers to the person who will be enjoying the activity (even if someone else is applying on their behalf).
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Your answer
Recipient's Birthday
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Your answer
Activity or item the funding will benefit
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Your answer
Awards are based on the CRDSS budget year, running from 7/1/2022 to 6/30/23. Has the recipient received an Enrichment Fund award during the current fiscal year?
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Yes
No
Required
If yes, how much funding was received and what was the purpose of those funds?
Your answer
Amount of funding requested
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Your answer
Date(s) of activity
Your answer
How will participation in this activity enrich the life of the recipient?
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Your answer
A copy of your responses will be emailed to the address you provided.
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