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Enter EACH Child/Youth's Info *Required

(Click on "Add Child" )

Youth Initials	Date of Birth	Case Number	Actions

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Enter EACH Child/Youth's Info*
(Use + button at right to add more rows) (Please use only 1 application per sibling group)
Youth Initials Date of Birth Case Number
Please detail your communication with the OCS Special Needs Hotline 855-603-8637*
(date of communication, who you spoke with and outcome of communication) or please note if Tribal custody only.
Please specify what attempts were made to obtain funding from other sources prior to applying for this grant.*
Name of Employer/Affiliation*
You must be a CASA volunteer, GAL, OCS or Tribal caseworker in order to apply for a grant.
Requester's Name*
First Last
Requester's Email*
Requester's Phone*
For camps, when direct pay is requested, provide business name and mailing address.
Requestor's Mailing Address (for reimbursement)
Amount Requested for each child*
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Amount per child
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Amount requested per child/youth or total request for the family.*
** Please note that funds must be encumbered by August 15. Any funds not spent or encumbered by that date will automatically lapse and the grant will close.
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Court Case Numbers for all children (or # of children if this Event or Group project)*
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Child's Name*
First Last
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Child's Age*
Detailed description and cost estimate of need(s)*
Is this a special request for an electronic device?*
If so, acknowledgment of FACC’s Policy on Electronics is required. View Electronics Policy Form here
- No
- Yes
A completed Electronic Policy Form is required for electronic devices (link is above). You may upload the completed Electronic Policy Form here.
Max. file size: 50 MB.
Acknowledgment of review of FACC grant policy*
Type your initials to acknowledge that you've read and agree with FACC grant policy: View Grant Policy
Date*
MM slash DD slash YYYY
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Acknowledgment of FACC’s Policy on Electronics
Max. file size: 50 MB.
Email
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Friends of Alaska's Children in Care

PO Box 242484, Anchorage, AK 99524-2484

info@friendsofalaskascc.org

Teresa K

Amount per child

Friends of Alaska's Children in Care

PO Box 242484, Anchorage, AK 99524-2484

info@friendsofalaskascc.org

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Teresa K