Application Form

Tobi's Fund is set up to help children and young adults up to age 35. Any Jewish children in the Mequon and Milwaukee area who have special needs may apply for funding.

Your request will be determined depending on what's available in the fund at the time of your request, and if your request meets the criteria of our fund. For now the fund could award grants of up to $300.00 per applicant.

Please provide the following information. 

* Denotes required field
 

Child's Name*
Parents Names*
Last Name*
Address Line 1*
Address Line 2
City*
State
Post Code*
Home Phone
Cell
 
Email Address*
Age of Child*
Birthdate*
Amount Requesting
For what Jewish program activity, or enrichment program are you requesting?*
Please share your story, and include a comment from a teacher, therapist or advisor to support your application.*