Angel Pups Around Us Overview — The Pearce Family Foundation

The Pearce Family Foundation (PFF) created “Angel Pups Around Us” to financially support children who are in need of a service dog. PFF will grant a portion (at least $1,500) of the funds needed to families that have a child (ages 5-17) who will benefit from the assistance of a service dog for medical reasons. Each grant is limited to one payment.

To qualify for the “Angel Pups” grant program each family must:

Live in Arizona and work with a “local” organization who trains and provides a service dog.
Family must secure at least 75% of the funding goal at the time of the application.
Submit an application for an Angel Pup grant
Apply only once a calendar year.

Applications are reviewed at the end of each quarter. Applicants submitting applications between grant cycles will be put on a “wait list” and be reviewed by committee in the next grant cycle. Please do not contact PFF to check on the status of your application, PFF will contact you. Once a family is selected to receive an “Angel Pups” award, PFF will hold the funds until the final payment is needed. If the family does not meet the goals by the end of the year, PFF will award the grant to another family.

All applications are kept confidential, but the applicant grants PFF permission to share pertinent medical information on the specific reason a service dog is needed in its materials about applicants and grantees.

PFF will not host individual events or fundraisers for a prospective “Angel Pups” family. It is the responsibility of the grantee’s family to raise the majority of the funds to pay for your child’s service dog. PFF’s grant is intended to be a final push to help families secure its service dog. PPF cannot meet every request, but we wish each family “good luck” in the efforts and we thank you for your interest in Angels Pups Around Us.

-The Pearce Family Foundation

Angel Pups Application

Child's Information

Child's Name:

First Name

Last Name

Diagnosis:

Gender:

Age:

Birthday:

YYYY

Address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Service Dog Training Information

Training Organization Supplying Your Service Dog:

First Name

Last Name

Name & Contact at Training Organization:

What kind of service dog are you requesting?:

Estimated Cost of Your Service Dog:

How much have you raised?:

Current Fundraising efforts (events, public support etc.):

Parent/Guardian Information

Parent or Guardian's Name:

Phone Number:

(###)

###

####

Email Address:

Gross Monthly Income:

Employer & Job Title:

Briefly tell us how a service dog would benefit your child.

Describe the Benefit Below:

Have you been accepted by an approved dog service provider?:

Funding

How will your family continue to fundraise for a service dog?:

Parent/Guardian Certification

I certify that the information given in this application is true and correct as of the date set forth opposite my signature and that any intentional misrepresentation of the information contained in the application will result in the loss of current and future assistance from Angel Dogs and may result in civil liability. The applicant releases the Pearce Family Foundation from any and all liability which may arise from the sharing of this information to third-parties. The Pearce Family Foundation reserves the right to run a background check on every applicant.

Parent or Guardian's Name (Signature):

Date:

YYYY

Relationship to Patient:

I understand that checking this box constitutes a legal signature confirming that I acknowledge and warrant the truthfulness of the information provided in this document.