Grant Application Process

Before filling out our application, please consider the following:

1. Are you a resident of New Hampshire?
2. Do you have a serious brain injury caused by a trauma, tumor or stroke which occurred within the past 2 years?
3. Are you in financial need as a result of your brain injury?
4. Does your request relate directly to this brain injury?
5. Will granting this request make a significant difference for your situation?
6. Have you exhausted all of your family's assests and resources before applying to us?
7. Have you contacted Maureen Long of the Brain Injury Association of New Hampshire (603)769-0203 to determine if you are eligible for the state's grant program?
8. Have you contacted all other resource options and applied for assistance? If you need information on other agencies or assistance programs please contact the Brain Injury Association of New Hampshire at (800)773-8400.

• If you answered yes to all of the questions, you are eligible to apply. We can either send you our application, or you can download it as an Adobe Acrobat PDF.

• Grant Application Form   PDF
• Medical Authorization Form  PDF
• Guidelines for Vehicle Assistance Grants  PDF
• Guidelines for Dental Assistance Grants  PDF

• Only complete grant applications will be considered. Complete applications include medical documentation detailing your brain injury, a letter answering the three questions listed on the Application information page, a detailed explanation of how you would spend this money including any estimates, bills or pricing information and documentation of contacts/applications made to other resources/grant programs and their decisions.
  

• Complete grant applications will be reviewed as they are received by the Executive Director of the Foundation and the Family Support Director.

• If you have any questions, please contact Lisa Hanson, Family Support Director at (603) 433-9821 or email familysupport@krempelsfoundation.org.
  

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