Funding Application to Access Support If you or someone you know needs access to an animal-assisted service but do not have the financial means, you can make an application for our charity to fund participation through this application process. OK Question Title * 1. Contact Details Name Company City/Town State/Province Country Email Address Phone Number OK Question Title * 2. Tell us a little bit about you OK Question Title * 3. Please tell us what you need help with Autism Visually Impaired Hearing Impaired Psychosocial Cerebral Palsy Acquired Brain Injury Stroke Multiple Sclerosis Post Traumatic Stress Anxiety or Depression Traumatic Brain Injury Diabetes Seizures Chronic Illness Other (please specify) OK Question Title * 4. If you are not successful at obtaining funding through this grant, do you have access to NDIS or any other funding that could facilitate your access to animal-assisted services? OK Question Title * 5. What type of support do you need? Animal-Assisted Therapy delivered by an allied health professional Animal-Assisted Learning delivered by a trained facilitator My own dog trained as my assistance animal Therapeutic Animal visits by a certified animal handler team. Funding to attend National "Animals Helping Humans Month and the conference Other (please specify) OK Question Title * 6. What animal would you prefer to engage with? Dog Horse Cat Llama / Alpaca Chicken Goats Other (please specify) OK Question Title * 7. Thank you for your time in completing this application and good luck. Unfortunately, we can not guarantee that your submission will be awarded with funding as we will not be able to fund all applications. Our board assesses all applications based on available funding and successful applicants will be notified by email. All decisions are final. Agree OK DONE