Bereavement Grant

AMCSI’s bereavement grant is available to any immediate family member of an AMCer who has passed away.

AMCSI will provide one grant of $500 for funeral expenses to the surviving spouse, parent/guardian or children of an individual with a confirmed medical diagnosis of arthrogryposis multiplex congenita.

These funds may be used to assist the family with any funeral expenses.

AMCSI’s Bereavement Fund is open to all members and nonmembers of AMCSI.

There is no age limit for the AMCer.

Funds must be dispersed to immediate family members only. Immediate family members are defined as spouse, parent/guardian or children.

The Bereavement Fund is open to all U.S. residents.

This application must be signed and returned with supporting documentation of the individual’s diagnosis and death.

Bereavement Grant Submission Form

All (required) (*) documents must be sent to info@amcsupport.org

Your application will not be processed until all required items are received.
Please do not email to check on the status of your application. We will reach out you if further information is needed.

Funding for this grant is available thanks to our AMCSI Members, Run 4 Jack, Rogers Run, 253 for AMC, Valerie Pepe’s AMC Bowl-A-Ton, Valerie Pepe’s AMC Music Festival and AMCSI’s Awareness Day campaign, Facebook birthday fundraisers & T-shirt sales.

Name

Phone

Address

Address 2

City

State

Zip

AMCer’s Name

Date of birth & death

AMCSI would like to extend our sincerest condolences and love to your family.

We would also like to offer to put your AMCer’s memorial picture (made by you or a member of the Board) on our AMC Angel memorial page located at a amcsupport.org/amc-memorials/.

Photo Upload (Image file must be under 10mg in file size)

Bereavement Grant

Bereavement Grant Submission Form

All (required) (*) documents must be sent to info@amcsupport.org

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