"The Lord is close to the brokenhearted and saves those who are crushed in spirit"
Psalm 34:18
SIDS America Financial Aid Application
Due to the needs we are currently serving, and the volume of applications received, we regretfully are unable to accept applications for financial assistance at this time. We are terribly sorry for your loss, and we would still very much like to help you through your grief in other ways. Grief support resources for SIDS families are available on our website here at http://sidsamerica.org/sids-resources. We can also connect you with other families who have suffered the death of a child to SIDS who are experiencing hope, healing, and joy in their lives again. We can visit with you personally to walk with you in this most heartbreaking time. Please call us at 800-815-1306.
In accordance with IRS guidelines for providing emergency hardship aid to individuals, SIDS America provides short-term assistance to individuals and families suffering an emergency hardship due to the sudden loss of a child to SIDS. Such aid is intended to assist families from suffering additional trauma due to unexpected cost related to their loss.
If your child has died of Sudden Infant Death Syndrome (SIDS) and you are in need of financial assistance for medical, funeral, burial, or grave marker costs relating to the child's death and/or you are in need of grief counseling for you or your immediate family, please fill out the application below in as much detail as possible. Having a family member, friend, etc. fill it out for you is ok as well. Once we receive the application, we will review it, then contact you to discuss the next step.
SIDS America reviews each application individually and determines the amount of aid that SIDS America is able to provide based on the individual/family need and funding available. Criteria used to determine aid to be provided include: (a) the type and amount of unexpected costs facing the family due to the loss of their child; (b) the financial hardship such unexpected costs will place on the family; and (c) the financial need for the aid and other resources available to the family to assist meet this need.
It's our desire to lift the heavy financial burden that we know you might be experiencing due to the death of your child. We want you to know that you are not alone, we appreciate you reaching out to us, and we truly want to serve you and your family.
Applicant Information
If you are a friend, family member, etc. filling this application out on behalf of the parents of the child, please provide your name (First, Last), phone number, email, and your relationship to the child and/or parents (i.e. - grandparent, aunt, uncle, sister, brother, friend, co-worker, social worker, etc.). If you are the father or mother, simply type your name (First, Last).
Child Information
Date of Birth
Date of Death
Did your child have a life insurance policy?
Did your child have health insurance?
Please also provide a contact name, phone number, and city/state.
Attachements
(If you need to upload a death certificate, you may do so here.)
Please provide contact name and phone number.
Additional Information
Please describe the expenses for which financial assistance is needed, such as funeral, burial, grave marker, or emergency medical costs associated with your child's death, or grief counseling for you or your immediate family.
Please describe how the unexpected loss of your child and the related financial expenses will cause you and your family additional hardship, such as inability to pay normal costs of housing, food, and transportation, depletion of all savings, loss of automobile, loss of job, etc.
If so, please describe what has been done and how much has been raised.
If so, please provide the company name(s) and contact name(s), phone number(s) and email(s).
If so, please list them here.
If so, please provide the name, phone number, and/or email of the group leader. If not, would you like more information about faith-based SIDS support groups in your area?
If so, please provide a contact name and phone number. If not, would you like more information on a grief counselor in your area?
If so, please provide your religious or denominational preference.
If so, please provide your religious or denominational preference.
Please feel free to include any additional comments and/or information above that you feel would help us better serve you.
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