Emergency Grant Application

 

Applications for aid are screened by the Social Butterflies Foundation Emergency Grant Committee                                                                                                                 who evaluate according to defined criteria.

Grant Guidelines:

• Grant requests will be accepted on behalf of any medically diagnosed person with lupus and/or
fibromyalgia residing within the following cities: Newport News, Hampton, Norfolk, Portsmouth,
Chesapeake, Virginia Beach, Suffolk, Poquoson, York, and Williamsburg. The grantee must be 19
years of age or older and offer satisfactory evidence that lupus and/or fibromyalgia has been
medically diagnosed including physician’s verification (Medical Release Form).

• The Social Butterflies Foundation financial grant MUST BE directly related to the treatment of lupus
and/or fibromyalgia or a “lupus/fibromyalgia-related” emergency. Grant requests are not accepted for
rent, mortgage, or car payments.

• Applicants must identify the need and demonstrate how a grant will either fully cover the need or
supplement personal or provider resources. Approved grants will be paid directly to the agency or
provider.

• Grant requests must be exhaustive – requests will not be considered if assistance is available through
ANY other sources (other organizations, government agencies, health insurance coverage).

• Grants are limited to two per 12-month period per person with a maximum of $500.00.

Examples of Financial Need:
Purchase of necessary medications or drugs (on physician’s orders), durable medical equipment
rental or purchase, rental or purchase of personal care items designed to improve functioning of the
grantee in activities of daily living (eyeglasses, hearing aids, specialized telephone equipment,
adaptive living devices, adaptive clothing, etc.), temporary subsidy for emergency and non-recurring
personal or living expenses to support the grantee’s own efforts (created by sudden loss of job, loss of
disability benefits, awaiting public assistance grants, awaiting other government grants or awards,
personal trauma or tragedy, overwhelming medical expenses, etc.)

 

Click the document picture below to get a printable version of the grant application.  Please complete fully

and and return the application to:

Social Butterflies Foundation | Attention: EGP

P.O. Box 1652 | Newport News, VA 23601