How We Can Help

Team Hoover offers small grants for individuals diagnosed with MS to help improve their quality of life.

These grants are designed to help pay for equipment, home improvements or other items that will assist in daily living. If you would like to apply, please fill out the application form and email it here to notify us of your submission.

PLEASE NOTE: Team Hoover cannot award grants for rent or utility costs. There are other resources available. One resource is through First Baptist Church. In addition, please check with your local social services office for information on non-profit programs in your community.

If you answered yes, please provide their contact information - Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

YYYY

Phone

(###)

###

####

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####

When Were you Diagnosed With MS?

Current Major Symptoms:

What Type of Assistance Are You Requesting and What is the Estimated Total Cost?

Are You Receiving Financial Assistance For This From Any Other Source?

Do You Have Medical Insurance?

Yes

Are You Employed?

Yes

Names and Ages of Dependents

PLEASE INCLUDE A WRITTEN CONFIRMATION OF DIAGNOSIS OF MS FROM YOUR PHYSICIAN, ESTIMATES OR PRICING FOR ASSISTANCE REQUESTED, AND ANY ADDITIONAL INFORMATION THAT YOU THINK WOULD BE HELPFUL BELOW.

Do you have an MS Navigator through the MS Society?

Yes

If you answered yes, please provide their contact information - Name

First Name

Last Name

Phone Number

(###)

###

####

How We Can Help

Team Hoover offers small grants for individuals diagnosed with MS to help improve their quality of life.

Keep In Touch With Team Hoover