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Sample Funding Request Letter

[Date]

[Name of Organization]
[Street Address]
[City], [ST] [Zip-Code]
Attn: [Name of Person]

Dear: [Call in advance and get the name of the person to contact]

I am writing to ask for your assistance for my [self, family member, etc]. Let me tell you about [whomever].

[Here, you put who the person is, what the disability is, what the need is. Include why the item would benefit the individual’s quality of life, documentation about the item, and any evaluations done by people who recommend the item. Include cost of item, any installation costs, and training costs if applicable.]

[Next, document all other sources of funding tried, and why they did not work for the person. Even if it seems obvious that a funding source (i.e. insurance) would not pay for an item, get it documented! Remember, this is a funding choice of last resort—they need to know you have tried all other options.]

Your assistance in any way is greatly appreciated. Please contact me at [contact phone number] if you need further information.


Sincerely,

[Your name here]

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