The Aidan Project - Scholarship Application

The Aidan Project's Scholarship program is intended to support families who would otherwise have no reasonable source of financial assistance for needed therapy services when state-subsidized therapy is unavailable. A formal diagnosis is not required. Eligibility is based on the child's documented or suspected developmental need, the recommendation for therapy services, and the family's lack of access to adequate funding through insurance, early intervention, a school district, or another public or charitable source. Scholarships will not fund adaptive equipment, durable medical equipment, assistive devices, or other supplies. Families will be considered when another funding source is unavailable, does not cover the requested service, or does not provide sufficient support to meet the child’s therapy needs.

Application Requirements

The applicant must be 10 years or younger on January 1 of the year scholarship funds will be used.
The applicant must be receiving therapy services to address a developmental delay or related developmental need. Examples include delays in speech, language, communication, motor skills, sensory processing, feeding, cognitive development, socio-emotional development, play, or adaptive and self-care skills. Children with diagnoses such as autism may qualify when therapy is addressing one or more of these developmental needs.
The applicant must reside in or receive eligible therapy services within The Aidan Project's 11-county service area: Johnson, Leavenworth, Miami or Wyandotte County in KS; or Cass, Clay, Henry, Jackson, Johnson, Platte or Ray County in Missouri.

Application Guidelines

The scholarship application opens September 1 and closes October 15.
All required application components and supporting documents must be received by The Aidan Project no later than 5:00 p.m. CST on October 15.
The caregiver applicant must reside in or receive eligible therapy services within The Aidan Project's 11-county service area: Johnson, Leavenworth, Miami or Wyandotte County in KS; or Cass, Clay, Henry, Jackson, Johnson, Platte or Ray County in Missouri.
The caregiver submitted the application may be asked to participate in a phone or virtual interview with an Aidan Project staff member.
Award decisions will be emailed to families at the email address provided in the application no later than December 15. Applicants must provide an accurate email address and monitor their email, including spam or junk folders.
Scholarship awards must be accepted no later than December 31. If an offer is not accepted by the deadline, the award will be forfeited, and the funds may be offered to the next eligible applicant on the waiting list.
Scholarship funds may be used for eligible therapy services provided on or after January 1 of the year following the application period.
All scholarship funds must be used for eligible therapy services received within that calendar year. Any funds not used by the end of the calendar year will expire and may not be carried forward. All bills must be submitted for payment no later than March 31 of the year following services.
Scholarship recipients will be required to complete an online follow-up survey and provide feedback about their experience and the child’s progress. The requested information must be submitted within 30 days after the funded therapy services conclude or by another deadline communicated by The Aidan Project.
Scholarship recipients may be invited to share a family story, testimonial, photograph, or artwork to help demonstrate the community impact of The Aidan Project. Participation in publicity or promotional activities is voluntary and requires separate written permission from the child’s parent or legal guardian. A family’s decision regarding publicity will not affect scholarship eligibility or funding.
Failure to provide required information or documents by the stated deadlines and in the requested format may result in application denial or award withdrawal.

Household Contact Information

First, please supply information about the parents or guardians that support the child or children, beginning with the household that provides the majority of support for the child.

You have the opportunity to add more than one address, and more than one set of parents/guardians.

Primary Household

How many parents/guardians in this household?

Parent/Guardian 1

First Name

Last Name

Email

Phone

Parent/Guardian 2

First Name

Last Name

Email

Phone

Parent/Guardian 3

First Name

Last Name

Email

Phone

Parent/Guardian 4

First Name

Last Name

Email

Phone

Parent/Guardian 5

First Name

Last Name

Email

Phone

Street Address

City

State

Zip/Post Code

Kansas County

Missouri County

Do you need to add another household?

Household 2

How many parents/guardians in this household?

Parent/Guardian 1

First Name

Last Name

Email

Phone

Parent/Guardian 2

First Name

Last Name

Email

Phone

Parent/Guardian 3

First Name

Last Name

Email

Phone

Parent/Guardian 4

First Name

Last Name

Email

Phone

Parent/Guardian 5

First Name

Last Name

Email

Phone

Street Address

City

State

Zip/Post Code

Kansas County

Missouri County

Do you need to add another household?

Household 3

How many parents/guardians in this household?

Parent/Guardian 1

First Name

Last Name

Email

Phone

Parent/Guardian 2

First Name

Last Name

Email

Phone

Parent/Guardian 3

First Name

Last Name

Email

Phone

Parent/Guardian 4

First Name

Last Name

Email

Phone

Parent/Guardian 5

First Name

Last Name

Email

Phone

Street Address

City

State

Zip/Post Code

Kansas County

Missouri County

Primary Household Financial Information

Please provide information for the household that provides the majority of support for the child.

Total Household Income Range

List your total household income for the past 2 years, line 9 from Form 1040. If your tax status is married, filing separately, please add line 9 from both returns.

Most recent year

Previous year

Total Number of household members (adults + dependents)

Total number of dependents in the household with therapy needs

Is the household a single parent household?

How much have you spent on all healthcare, year-to-date?

What scholarship amount are you requesting?

Tax Returns

Please upload copies of your tax return from the last 2 years. The file must be in .pdf or image form.

Please include only the first 2 pages and Schedule 1.

Most recent tax return

Prior year tax return

Child Applicant Information

Please provide information for each eligible child with therapy needs. All families are different, and each child may have different insurance, demography, or providers. Please complete the information for each child, even if it is the same for every child in your household.

Each Child

Child First Name

Child Last Name

Date of Birth

Demographics

These questions align with data values established by the US Census Bureau. They are imperfect, but familiar. You are invited to self-identify as appropriate for your family.

Gender

Self-Identify Gender

Race

Select one or more values, or self-identify. On PC, hold CTRL key to multi-select. On Mac, hold COMMAND ⌘.

Self-Identify Race

Therapy Needs

Does this child have a diagnosis?

On PC, hold CTRL key to multi-select. On Mac, hold COMMAND ⌘.

List all medical and clinical diagnoses for this child

How long has your child been receiving therapy services?

Is your child receiving the recommended amount of therapy?

Are your child's therapy needs likely to be resolved in a year or less?

What is the recommended increase in therapy services?

How much progress have you seen through therapy?

We hope every child is making progress toward their goals, so please don't hesitate to state this.

Select the discipline(s) in which your child receives therapy. (Select all that apply)

On PC, hold CTRL key to multi-select. On Mac, hold COMMAND ⌘.

Other therapy needs

Health Insurance

Which statement best describes this child's health insurance status?

Summary of Benefits

Please provide a copy of the "Summary of Benefits" for the child's insurance plan. Do not provide the entire policy. If you are applying for multiple children under the same policy, please attach the same Summary if it applies. Thank you.

What is the individual deductible?

What is the family deductible?

What is the out of pocket maximum?

Visit Limits and Costs for Each Discipline

Occupational Therapy

Max Visits per Year

Cost per Hour

Hours per Week

Speech Therapy

Max Visits per Year

Cost per Hour

Hours per Week

Physical Therapy

Max Visits per Year

Cost per Hour

Hours per Week

ABA Therapy

Max Visits per Year

Cost per Hour

Hours per Week

Other Therapy

Max Visits per Year

Cost per Hour

Hours per Week

Describe what services you are seeking for your child

Explain why you are seeking services

Therapy Provider

Clinic/Provider must complete Scholarship Application Referral Form. The Aidan Project will send the form directly to all therapists listed below.

Clinic Name

Provider Name

Clinic/Provider Phone

Clinic/Provider Email

Provide a copy of a recent therapy bill:

Has your child received therapy services anywhere other than the clinic(s) listed above? If so, what was the outcome?

Does your child currently receive services or accommodations from the school district? If so, what are those accommodations and services? (type, frequency, etc.)

If you are applying for a scholarship for multiple children, please "Add another response" for each child.

Family Summary

Please describe the special circumstances that may affect your family's ability to pay for therapy services.

Have you received any other financial assistance (other nonprofits, family, etc.) to help pay for therapy?

Is there anything else you would like us to know about you and/or your family?

About your application

All of the information I have provided in this application is accurate and is subject to verification by the scholarship provider at its discretion. I understand that all information contained within the scholarship application will be held in the strictest of confidence.

It can take a moment for this application to process after you hit Submit. Please wait until you see the message confirming your submission before navigating away from this page. Thank you!

Signature of parent or guardian:

Date: