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Golden Ticket Award

A monthly $100 grant for deserving individuals with special needs.

Please fill out the form below to submit online. We must have a means to contact the individual you are nominating as well as his or her parent/guardian or residential provider to confirm the individual’s disability and financial need.

Nominate Here!

Nominee's Information

Name of Nominee
Nominee's Address

Parent (Guardian) and / or Residential Provider

Guardian's Name

Nominating Person's Information

Your Name

How will this individual benefit from receiving this grant? Please be as specific as possible with your reason(s) for nominating this special needs individual.