We want to let everyone know that the Cerebral Palsy Association of Manitoba (CPMB)
has never and does not use phone solicitation looking for donations.
If you have a concern, call David Kron, Executive Director, CPMB at 204.982.4842.

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):