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LymeAid 4 Kids (LA4K) Grant Application

Lyme Aid for Kids Application Form

LymeAid 4 Kids (LA4K) Grant Application

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LA4K Grant Application Instructions

  1. Print the Application:  Click the button below to download and print the Grant Application Package.
  2. Complete Your Part:  Fill out the Applicant Certification Form and give the entire package plus the first page of your IRS 1040 to your provider.
  3. Provider Completes and Sends:  Your provider fills out their form and emails the completed package to COTBDAA.
  4. Submit Follow-Up Form:  Once your provider has received the package, complete the online Follow-Up Form below so we can track and update you on your application status.

LymeAid 4 Kids (LA4K) Application Follow-up Form

Applicant is the Parent/ Guardian of applicant 21 years or younger or the name of the independent person between 18-21
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