Grant Application

These grants are awarded once per year on February 15th. Applications become available for submission from October 15th and are due no later than 5:00 p.m. on January 15th. Applicants will be notified no later than 30 days after the selection date.

Grants are awarded based on the requested material as well as need. Applications will be accepted from applicants within a 75 mile radius of Lawrence, KS and the State of Kansas with priority given to those in Lawrence and Douglas County. We will help as many families as our funds will allow. As our funds grow, so will the number and the amount of help we will be able to give. Ineligible requests such as medical bills that have already been paid, submitting for food, clothing, laundry fees and anything deemed non-medical for your child will not be acceptable criteria to submit for a grant request. The awarded funds will range depending on the number of recipients and need.


Two Ways To Apply



Option 1: Apply By Mail

You can download the Cooper's Cause Foundation Grant Application in either Microsoft Word or PDF format.




Option 2: Apply Online

To apply online using the CCF secure upload form, please follow the steps below.

Using the Secure File Exchange form below, click on the Secure Upload link. Then attach Word or PDF documents with the following required information. Address each question asked, specifically and completely.

  1. General Contact Information (include the following)
    • Name of person completing this form and relation to child
    • Child's Full Name
    • Mother/Legal Guardian Full Name
    • Father/Legal Guardian Full Name
    • Address
    • City
    • Contact Number (Home, Work, Cell)
    • Email Address
  2. Please tell us in a concise manner about your child’s condition and prognosis.
  3. Please tell us about your immediate family. *Please include siblings and their ages.
  4. Please attach the explanation of benefits from your insurance carrier and also, attach the coordination of benefits statement from your secondary insurance, if applicable. Also, please provide information on any other funding you have received for your child’s condition.
  5. Please provide a copy of your most recent tax return.
  6. Please explain what you would like to have paid and who that payment should be made payable to. Please provide and itemized page with the name of organization to be paid, their telephone number, account number, date of service and amount to be paid.
  7. Please attach any medical bills you would like to have paid. Copies are acceptable.
  8. Please explain any other related bills that you have and wish to be paid because of your child’s condition. (I.e. Ronald McDonald House expenses, prescriptions or out of town treatment expenses)
  9. Download and complete the Permission form and attach it.