Sponsorship Application

The document is a sponsorship application for speech and language therapy provided by the Scottish Rite Childhood Language Disorders Clinic.

Introduction Summary

The Scottish Rite Childhood Language Disorders Clinic in Billings, MT, offers a sponsorship application for speech/language therapy, requiring detailed information about the child, family, and prior therapy. Contact details include a phone number (406-259-6683) and email (secretary@billingsscottishrite.com). The application was revised and adopted on 11/17.

Application Information

This section outlines the application process for Scottish Rite sponsorship for speech therapy, including financial and medical information.

• The application requires the name of the parent representing the child and marital status.
• Annual income from the last two Federal Income Tax returns must be reported for both parents.
• Applicants must disclose assets, including approximate equity in their residence and savings, along with liabilities like monthly expenses and debts. Medical insurance details, including coverage for speech and language therapy, must be provided.
• The application process includes a clinical assessment by a licensed speech therapist and an interview with the Scottish Rite Board of Directors.
• Sponsorships are granted for six-month periods and are contingent on compliance with program policies and available funds.

Authorization

The undersigned confirm the application information is accurate, signing on a specified date.

Download Sponsorship Application