SAM’S SPOONS GRANT APPLICATIONIS CLOSED

For questions or concerns please email info@samsspoons.org

SAM’S SPOONS GRANT APPLICATION

Wellness Grant applications will open October 17th and will close on November 19, 2025 at 11:59pm” The application is now OPEN.

For questions or concerns please email info@samsspoons.org

Your Email

Name (First & Last)

If applicant is under 18, name of parent/guardian

Street Address 1

Street Address 2 (if applicable)

City, State

Postal Code

County

Phone Number

Applicant's date of birth

Amount Requested (Up to $2,000)

Receipts

Qualified recipients must be able to provide receipts of provider services, treatments, supplements or other wellness intervention. If selected, applicant will be awarded up to $2k to reimburse out of pocket expenses.

Reason for Request: Include as much information as possible to help us consider all aspects of your situation and need.

Do you (applicant) or your family have a relationship with anyone on the Sam's Spoons Foundation Board?

If yes, please explain the relationship

Permission to use Name/Photo on SSF website, social media and, if possible, to accept the check in person on a designated day. If YES, please email photo to info@samssppoons.org by the application deadline.

YES, I give permission to use my name and photo (or loved ones name if completing application on their behalf) NO, I do NOT give permission to use my name or photo

SAM’S SPOONS GRANT APPLICATIONIS CLOSED

SAM’S SPOONS GRANT APPLICATION

Receipts

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