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Barbara Fierst Memorial Technology Grant

Mountain State Council of the Blind
Barbara Fierst Memorial Technology Grant
Application Form for Assistive Devices

Assistive devices, not to exceed $500 may be provided by MSCB to eligible applicants. Only one application per individual may be submitted annually. Applicants must be at least 18 years of age and a resident of West Virginia.

Please complete the following online application form, or download application form and return to:

Donna Brown, Awards Committee Chair
Mountain State Council of the Blind
PO. Box 188
Romney, WV 26757

This organization guarantees that your personal information will not be shared with any persons or parties outside the Awards Committee. Decisions of the Awards Committee are final.

A recipient of this grant is requested to pay one year MSCB membership dues in the amount of $10.

Online Application Form

 
1 Start 2 Complete
ONLINE Barbara Fierst Memorial Technology Grant Application
Personal Information
Presently in school? *
Technology Device Information
Upload statement of how you plan to use this device. Hit "Browse" to select your file, then "Upload".
Files must be less than 2 MB.
Allowed file types: txt rtf pdf doc docx.
Have you investigated other funding resources? *
Should the device no longer be needed, do you agree to return the device to MSCB for continued distribution? *