Respite Care Application

Welcome!

If you're coming from YourRespite, you are in the right place. Special Needs Respite now provides childcare previously supplied through YourRespite.

This application is for applicants who receive benefits through programs such as ISDD/Project GRANDD, NOW, or BDI, or who are self-funded.

This application ALSO is for those who are not beneficiaries of those programs, either because they are on the waiting list, or have not yet completed any of those applications. If you are one of these applicants, then you would be requesting funding through our Scholarship Program to pay for childcare, and may or may not already have a caregiver.

If you have previously applied and have recieved funds through SNR's Scholarship program, please use the Scholarship Reapplication

Also, by submitting this application, you are agreeing to receive email and text messages from Special Needs Respite to inform you of your application submission and progress, as well as make you aware of what we're doing to help parents of special needs children.

Enter the parent or primary caregiver's first name here. If you are an agency, please enter the parent's name.

If you are an agency or social worker completing this for a client, please enter your first and last name here.

If you are an agency or social worker completing this for a client, please enter your email here.

Indicate here what diagnosis or challenges your child has received that would qualify them as special needs

Please enter here how you intend to pay for services. If you do not have a funding source, including self-funded, select "No Funding Source" as well as any waiting lists you might be on.

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