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The Hart Speech Foundation

The Hart Speech Foundation

Advocacy. Support. Scholarships.

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Scholarship Application

Please complete the application below in full and hit submit. There will be a rolling notification process based on the start date of the program applied for. Applications must be completed in their entirety in order to be considered. The exact scholarship amount to be awarded will be determined at a later date. As a general rule, scholarships will not be greater than $2,000 and not less than $500. The HSF reserves the right to increase the amount of the scholarship if an exceptional situation exists. 

If a scholarship is awarded and you are subsequently reimbursed for services by an outside source such as a school system, insurance company, or other third party payer, you shall repay, in full, the scholarship fund the amount you were awarded. Your submission of this application serves as your understanding of this policy. 

Please feel free to follow up with an email to dphartlaw@verizon.net with any questions you may have. 

Scholarship Application

Section One: Applicant Information

Name of Applicant(Required)
MM slash DD slash YYYY
Address(Required)
Is applicant 18 or older?(Required)

If you have answered "No" to the question above, the following section must be filled out if you would like us to consider your application.

Name of Parent or Guardian #1
Name of Parent or Guardian #2
Address of Parent or Guardian
Parents/Guardians or Applicants Combined Annual Household Income(Required)

Section Two: Written Statements

TO BE WRITTEN BY THE PERSON SEEKING A SCHOLARSHIP AND/OR PARENT(S) or GUARDIAN(S).

TO BE WRITTEN BY THE PROSPECTIVE PARTICIPANT:
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HART SPEECH FOUNDATION | 85 Boatwright’s Loop, Plymouth, MA 02360 | 617-852-8855 | info@hartspeech.org

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