Different Iz Good™
Making a Difference for Those With Differences
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Gift a Voice Application
Thank you for reaching out. **Nevada state residents receive priority and we are only gifting donated iPhones and iPod Touches at this time*** Please read the Eligibility Requirements before completing the application. You will find them on the main Gift a Voice page. A response is required for every section. In addition, we require a speech pathologist report indicating the recipient is speech impaired, minimally verbal or non-verbal. This can be emailed to voice @ differentizgood . org or mailed to Turning Views Foundation, Gift a Voice Project, PO Box 19812, Reno, NV 89511. Please also understand that we are a very small 501(c)3 nonprofit organization. We genuinely and honestly want to assist all of you. Thank you for your patience with us!
Name
Recipient
Diagnosis
Relation
Email Address
Diagnosis
Recipient's Diagnosis:
Address
Address: City: State: Zip Code: Phone Number:
Income
Gross Two-Income Family: OR Gross Single Income Family:
School Assistance
Have you contacted your local school district (if recipient is of school age) about getting an iPod Touch or iPad for communication purposes?
Local Charities
Have you contacted local charities about getting an iPhone, iPod Touch or iPad for communication purposes?
Type of Device
Does the recipient need an iPhone, iPod Touch or iPad? Keep in mind we can get iPhones and iPod Touches to you quicker as we use donated last generation iPhones and iPod Touches. We suggest you only request an iPad if the recipient cannot physically use the iPhone or iPad (has MS or some other limitations with their hands or fingers). Recipients who have the motor skills and ability to use an iPhone will receive priority as we actively collect last generation iPhones and have them on hand. It will take us longer to get an iPad.
Reason
Why are you applying for assistance?
References
Please list three people who we may contact to receive a personal reference about you (Non-family members only). Please provide name, address, and phone number.
Story
Yes or No - If you are a recipient of this grant are you willing to share your success story with others?
Media
Yes or No - Do we have your permission to use photographs, name and descriptive information of recipient on the organization's website, Facebook Page, Twitter, YouTube and/or other media?
Date Submitted
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