Financial Aid Requirements & Application

Financial Aid Application and Requirements

Requirements

In accordance with IRS guidelines for providing emergency hardship aid to individuals, the Josephine DeMello SIDS Foundation provides short-term assistance to individuals and families suffering and emergency hardship due to sudden loss of a child to SIDS or any other causes. The Josephine DeMello SIDS Foundation reviews all application and will determine the amount of aid based on family needs and available funding. Please allow a minimum of 5 business days for the result of your application.

The following paperwork needs to be submitted with the application form:

Your local Public Health Department (MCAH) SIDS Services Report
Coroners preliminary diagnosis report
Please provide a death certificate

Application Form

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Name of Child *

Date of Birth *

Death of Death *

Coroners Report *

Max file size: 20MB

Death Certificate *

Max file size: 20MB

SIDS Service Report *

Max file size: 20MB

Describe Financial Assistance Needed *

DESCRIBE FINANCIAL DIFFICULTY CASUED BY THIS EMERGENCY HARDSHIP *