2026 Speech Tablet Grant Application

Date of Birth(Required)

Parent or Guardian

Contact Email(Required)

Contact Phone(Required)

Alternate Phone(Required)

Please do not use your work phone number

Alternate Email(Required)

Please do not use your work email address

i.e. Speech Therapist, BCBA or other professional that will assist child and family with use of speech application

Professional's Email(Required)

Professional's Phone Number(Required)

Upload diagnosis documentation(Required)

Please upload documentation to provide proof of the diagnosis/diagnoses of the individual(s) for whom you are seeking the grant.

Accepted file types: jpg, gif, png, pdf, Max. file size: 50 MB.

Mailing Address