Shinstrom Award for Special Needs Children

Donate to the Shinstrom Fund

The purpose of this fund is to grant awards of up to $1,000 to support extracurricular activities of a special needs student in the Lake Washington School District. These may be hobbies or interests of the student at the middle and high school levels. The Shinstrom Fund is a 501-C-3 tax exempt Foundation.

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Shinstrom Award Application

There are no merit-based criteria for this award, only a need and a desire for enrichment from middle school or high school students in the Lake Washington High School District

Applicants may qualify if they have an educational IEP or 504 Accommodation Plan, or if they meet federal guidelines for persons who are regarded as having a disability, impairment, or special need. This may be supported by a medical diagnoses or other acceptable record or history of such an impairment. Applicants who meet any of these criteria are eligible for this award. The application process is open year-round.

Please fill out and submit the form below:

"*" indicates required fields

CONTACT INFORMATION

Name*

First Last

Phone*

Parent or guardian email*

Address*

Street Address Address Line 2 City State ZIP Code

APPLICANT MATERIALS

Please provide the following documentation:

Applicant Details*

Please provide a description of your particular special need, challenge or disability, including any clinical or medical diagnoses.

Letter of Recommendation

Please upload one Letter of Recommendation from a Teacher or Counselor. You may also mail us a physical copy of this information.

Max. file size: 32 MB.

APPLICANT QUESTIONS

Applicants are evaluated by the Shinstrom Award Committee on the following criteria:

Interest/Hobby*

What project, activity or training would give you the most joy?

(Please describe your hobby or interest and what you would like to do.)

What is the maximum anticipated financial need for this activity?

(Please list itemized estimates of costs. We want to cover as much of your financial need as possible, so please include any and all costs that you can think of.)

Parent or guardian Signature*

Date

CAPTCHA

The information in this application will be used by Kirkland Kiwanis solely for the purpose of reviewing the applicant’s eligibility for an award from the Fund. The information will be kept confidential and not used for any other purpose.