During the current postal strike, please keep an eye out for emails from the office.
We do take online donations, Click Here or via e-transfers.
Please call or email the office to make arrangements for membership renewals,
Personal Support Worker forms and to use Credit Cards. Thank you.

Grant Application

Member Details:

Member Name:
Member Address:
Member City:
Member Province:
Member Phone:
Member Email:

Contact Name:
Contact Address:
Contact City:
Contact Province:
Contact Phone:
Contact Email:
Date of birth of member with cerebral palsy:
Has the applicant/family been a grant recipient in the past?
Is the applicant/family a current member of the CPMB?

Grant Request Details:

Total Requested Amount:

What is the request?

Please upload any quotes (PDFs only) here (maximum of 2MB per file).



How will this request assist the individual/family in areas of personal, educational
and/or social development leading to a more independent and quality lifestyle?

If your life situation stays the same, how will the acceptance or denial
of this grant request affect your lifestylle and opportunities?

Please name all other funding sources that you have contacted:

What is the response from these funding sources regarding your request(s)?
Please be specific.

How will you obtain the additional costs not covered by CPMB or other funders?

Please provide any additional supporting documentation if applicable (PDFs only) here (maximum of 2MB per file):