What Are We Doing About The 15,500?

Today, the 15,500 in Indiana are numbers on a piece of paper. Tomorrow, we hope many of the over 150 in our local area will be receiving services - at least at a minimal level – until they come to the top of that list.

Please turn to the back page for information on applying for funds for services. To receive an application, contact Kathi Thompson (574-753-4104 ext. 128 / kthompson@peakcommunity.com) or go to the Foundation website: www.foundation.peakcommunity.com.

How It Works

Parents/Guardians and/or Applicants must complete and sign the application information to the best of their ability.

Applicants must provide proof of being on a waiting list for waiver services for persons with developmental disabilities.

Applicants must provide up to one 8.5 x 11 (handwritten or typed) page of information that explains the circumstances surrounding the need for support.

Applicants must identify which support services they are requesting.

If the above tasks are not completed, the applicant will be disqualified.

The Peak Community Services Foundation will provide funds for support services to men, women and children who are on a waiting list for waiver services.

Recipients must agree that once they come to the top of the list and are offered government funds, they will report this change in status to the Peak Community Services Foundation.

Assuming funds are available and services are still offered by Peak Community Services, the Foundation will maintain funding for each applicant chosen until government funding begins.

For the application form itself, applicants will need to gather the information referenced below.

Additonal Information For Application

Total Dependents in Household and their Ages

Primary Wage Earner’s Annual Gross Income

Secondary Wage Earner’s Annual Gross Income

Other Annual Income

Total Household Bills (Monthly)

Applicant’s Types and Severity of Disability

The Type(s) of Waiting List the Applicant is On (Autism, DD, Support Services, Aged & Disabled, Other)

Date the Applicant was Placed on the Waiting List

Organization(s) Providing Support / Types of Support Provided

Other Sources of Support