Jane's Angel Fund—Application Process
Step 1: Complete the application packet. You may either:
Complete the online application:
Download and fill out the application (PDF). Make sure you complete each section and sign the application packet on the last page:
Step 2: Once your application is received, we will provide notification to you by email or phone. If you do not hear from us, please contact Anna Zelinske, at (314) 432-7257 ext. 237 or firstname.lastname@example.org.
Step 3: Applications received are reviewed according to the table below. If applying with the PDF application, please include all back up documentation with your application. If applying online, please send copies of all back up documentation to email@example.com.
Step 4: After your application is reviewed you will be notified of the outcome. If you receive a denial letter, that letter will contain the reason(s) for denial and an offer of assistance in finding other community resources, if applicable. If you receive an approval letter, the check will either be included or it will be noted that the check was sent to the vendor on your behalf.
Application and Award Deadlines
|Grant Period:||Reimbursement requests
must be received by or
|Required forms should be
submitted with receipts/invoices
and these must be dated between:
|Dec. - 1 Jan. 15||Jan. 22, 2021||Dec. 1 - Jan. 15||Feb. 1, 2021|
|Jan. 15 - April 15||April 23, 2021||Jan. 12 - April 15||May 3, 2021|
|April 15 - July 15||July 23, 2021||April - 15 July 15||Aug. 2, 2021|
|July 15 - Oct. 15||Oct. 22, 2021||July 15 - Oct. 15||Nov. 1, 2021|
|*||Dec. 3, 2021||Dec. 15, 2021|
*This is a special application period and dependent on available funds
Award Review Process
The Angel Fund Committee will meet after each application deadline to review submitted applications. The Care Services Coordinator assigned to the applicant will contact the applicant to discuss the outcomes of the approval process, including the reason(s) for a denial. An award payment may be provided to a vendor, to the patient, or to the patient’s designee, and is determined based on the application.
Program Evaluation and Feedback
All applicants to the grant program will be given the opportunity to provide feedback on a satisfaction survey that will be mailed to all recipients of grant funds.
The ALS Association St. Louis Regional Chapter assumes no responsibility or liability for any direct or indirect services, products or client care that the family chooses. We assume no responsibility or liability for the care arrangements and/or business relationships between the patient with ALS and their selected product or service provider.
Along with your application you may need to complete any of the forms listed below that might be required before grant funds are paid. Your Care Services Coordinator will help you determine which of these forms are required. Also, please be aware the program requires applicants to submit receipts, proof of payment, and/or an official quote from a provider/vendor before we disburse payment to the applicant.
Please submit materials to: firstname.lastname@example.org.
*Respite Care only
This form is for respite care providers who do not live in the patient’s home. The form MUST be completed by the care provider and sent in with a completed reimbursement request form.
*NOTE on Respite Care Reimbursements: If the care provider is not a professional provider, they must complete this care provider log included with the approval letter and attach it to the completed reimbursement request form. If the care provider is a professional provider, a copy of the actual receipt from the professional provider must be attached.
This form should be used when The ALS Association will pay directly to a professional provider or vendor. You must submit a copy of original Invoice or quote from the Provider or Vendor.