• To apply for a Ben’s Fund grant, you must upload all required documents listed below when you submit your application. 
• Please review the information carefully – incomplete applications cannot be submitted. 
• We can only accept one file per upload. If your document is more than one page, please submit as a PDF, or Word doc.
• If your document is a single page and you are uploading it as a jpeg, the picture must be clear and cropped with nothing in the background. 

In as many words as you feel comfortable, tell us about your child or young adult and how the requested equipment or services will support their autism journey. If there are any extenuating family circumstances you would like us to consider, please feel free to include them. Your story helps us better understand your needs and how we can best support you.

✅ You can either type your family story directly in the online application or upload it as a file.

• Your child’s name and date of birth
• Confirmation of an autism diagnosis
• The service provider’s signature

• MDs
• PhDs
• Licensed psychologists
• Board-certified/eligible neurologists
• Psychiatrists
• Developmental pediatricians
• ARNPs
• COE providers

To qualify, your family’s adjusted gross income (AGI) must be at or below 400% of the Federal Poverty Level (FPL), based on household size. Household includes everyone living together and sharing living costs (parents, children, dependents, extended family). If you receive child support, you must include it in your household income and provide documentation

✅To view our Income Eligibility Table, Click Here.

To verify these requirements, we request either a Tax Return or Supplemental Security Income Award Letter. Both documents must show a Washington State address.

Submit one of the following required documents:

• Tax Filers: 2024 Form 1040 (pages 1 & 2) for all household members, listing your child as a dependent — even if you earned no income
• Non-tax filers: 2025 SSI Award Letter listing your child as a beneficiary, dated within 90 days

Notes:

• You must provide one of these two documents. Applications without either will not be accepted.
• Young adults 18–25 must include household income if living with guardians
• If your child is claimed on someone else’s taxes, contact us for guidance
• Additional documents may be requested to verify income and residency, but cannot replace the required documents above
• If your family income is above our limit, you may share an extenuating circumstance in your family story.
• We do not accept W-2s, 1099s, bank statements, 1040s from before 2024, SSI award letters older than 90 days, Social Security, SSDI, Washington State Department of Social and Health Services (DSHS), or Apple Health.

Provide a referral letter from a qualified professional (doctor, therapist, special education teacher, or other professional supporting your child’s autism treatment) recommending all equipment or services you are requesting as a medical necessity, including duplicates.

Each letter must:

• Be dated within the last year
• Be on official letterhead from the service provider
• Be signed by the professional
• Clearly explain how each item or service will support your child’s autism treatment
• Any items not listed in the letter will not be considered
• If young adults do not have access to the professionals listed above, we can accept a referral letter from a case worker

Before You Apply

To make the application process easier, please be prepared to:

1. Choose your request type.

• You can select up to 3 types of items or services: Therapeutic & Safety Equipment, Therapy, Services, Camps, or Assistive Technology.
• You may request up to 20 items total from no more than 3 vendors.
• We recommend choosing larger, more meaningful items to make the biggest impact for your child or young adult.

2. Prepare your invoice table.

• You will need to list each item individually, including item name, cost (with tax and shipping), and a direct website link or vendor.
• For iPads (Assistive Technology), select the option from our iPad pack options below to enter.

3. Gather your invoices.

• For services, camps, or therapies, have an invoice or estimate ready to upload.
• For therapeutic & safety equipment, invoice upload only required for vendor quotes for large items (e.g., a Springfree Trampoline). Do not upload general website lists.

Guidelines to keep in mind:

• Grants cannot exceed $1,000 total, including tax and shipping.
• Only items listed in your referral letter can be funded.
• Ben’s Fund purchases items directly from vendors and ships them to your home — funds are not given to families.
• Ben’s Fund cannot register your child for services.
• If awarded, we purchase all items at once and make a one-time lump sum payment to the service provider.