Apply For Assistance

To Qualify

Suzy Foundation is passionate about helping individuals with special needs. Please complete the entire application below and attach the necessary documents.

1. If applicable, include a letter or prescription from the applicant’s doctor confirming the need for the requested assistive device.

2. A copy of parent(s)/guardian(s) most recent Income Tax Return (IRS Form 1040) with copies of all supporting W-2 forms. All information is confidential and treated with the utmost sensitivity for your security. Please black out your social security number. All documents will be shredded once a decision has been made.

3. Your application will be valid one year from its submission date.

4. Incomplete applications will not be accepted. If denied, Suzy Foundation

will review your application throughout the year if additional information is submitted for reconsideration.

5. Suzy Foundation considers each applicant on an individual basis.

6. Please mail the completed application to Suzy Foundation, P.O. BOX 24877,

Tempe, AZ 85285 or submit online

7. Must live in the Phoenix/metropolitan area

8. Individuals may only receive assistance once per calendar year.

Please be advised that the Suzy Foundation will directly purchase the assistive device for the applicant. Suzy Foundation does not provide funds directly to individuals.

Ready to apply? You can download the form, fill it out and email the completed form with the required documents to: Suzy Foundation at [email protected]

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