Application for Financial Assistance Application for Financial Assistance Requirements for Financial Assistance: At this time, it is anticipated that ARCHway Institute will provide financial assistance to those applicants that can successfully prove: That such person is impacted by a substance use or co-occurring mental health disorder That such person requires financial assistance to maintain their recovery from said substance use or co-occurring mental health disorder That such person has a recovery plan, increasing their chances of maintaining their recovery General Information about Financial Assistance through ARCHway Institute: A maximum of $500 is provided for individual financial assistance. Financial assistance is always awarded to the organization where the individual is receiving services. Financial assistance is NOT awarded to the individual themselves. Once the individual has completed the application for financial assistance, the organization where the individual is receiving services must complete the following grant application and be approved as a quality treatment/recovery provider. Once the organization has been approved, the individual will be notified of financial assistance. ARCHway releases funds as soon as they become available. If ARCHway is unable to grant your initial request for financial assistance, you may apply again at a later time. ARCHway responds to all requests for financial assistance within 48 hours. Apply Below Name * Email * Phone Number * About You arrowup1 Would you mind answering a few questions to help us better understand your needs? This information will not be used for discriminatory purposes. It will be used to ensure that ARCHway is servicing as many and as wide a variety of people as possible. Only pertinent ARCHway staff members will have access to this information. Your responses will be kept private and secure. Demographics What is your date of birth? What is your zip code? What is your gender identity? Do you identify as a person with a disability or are you a person with accessibility needs? Yes (describe)Yes (describe) No Prefer not to say Which racial/ethnic groups best describe you? (select all that apply) American Indian or Alaska Native Asian Black or African American Caucasian (light-skinned; of European origin) Hispanic or Latino Native Hawaiian or Other Pacific Islander Prefer not to say What is the highest level of education you have completed? Select one. Some high school, no diploma High school diploma or GED Some college, no degree Associate (2 year) degree Bachelor’s (4 year) degree Master’s degree Doctorate degree Prefer not to say Please list the mental health/addictive disorders you are seeking financial assistance for: * I need financial assistance for: * Treatment Services Recovery Housing Service OtherOther In the space provided, please provide the name of the organization for which you are seeking financial assistance including contact information for the organization. (If you have not chosen an organization yet, note that instead). Facility chosen (or type none) and city, state and contact person (name, email, phone number) Are you currently employed? * Yes No ARCHway’s scholarships are a maximum of $500. Do you have other sources of income to cover your expenses? Please describe: * What social supports and resources are you engaged with, or do you plan to engage with to best support your recovery (i.e., relationships, family, friends, social groups, support groups, co-workers, etc.)? * What local community resources are you engaged with, or do you plan to engage with to best support your recovery (i.e., treatment, housing, training, employment, transportation, education, etc.)? * What personal internal resources do you have to support your recovery (i.e., personal skills, values, education, health, hopes, and aspirations)? * What current obstacles or barriers are preventing you from progressing in your recovery? How do you plan to overcome these barriers? * Attachments Letters of Recommendation: We ask that you provide ARCHway with 2 letters of recommendations. These letters can be from a family member, counselor, case manager, peer, doctor – individuals who can attest to your current recovery status. Proof of Financial Need: This can be in the form of a paycheck stub, list of income and expenses, proof of employment or unemployment, etc. You can upload the forms below, email them to Emily.Stuckey@TheARCHwayInstitute.org or mail them to ARCHway Institute c/o Emily Stuckey PO Box 473 Wentzville, MO. 63385-9998 Upload attachments: 2 letters of recommendation and proof of income * Drop a file here or click to upload Choose File Maximum file size: 67.11MB CAPTCHA If you are human, leave this field blank. Submit
