Financial Aid

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2026 MUD RUN!

HOME
ABOUT
- Our Mission
- FAQ
- Blog
GET INVOLVED
CONTACT
DONATE
2026 MUD RUN!

Thank you for your interest in Hollis Adams!

The following form may be used to request financial assistance.

Please note:

Completion of this financial aid form does not indicate registration with Hollis Adams. Please be sure to schedule a tour if you haven’t already.
Completion of this form does not guarantee financial aid.
Financial aid applications will be reviewed monthly. If you have questions about the status of your application, please contact ben@hollisadams.org
Aid will be disbursed according to need. Applications could receive the full amount requested, partial amount, or be declined. Hollis Adams often receives more applications for financial aid than can be fulfilled.

Financial Aid Request

Applicant's Name

First Last

Applicant's Phone

Applicant's Email

Applicant's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

I am requesting support in order to:

Continue participating with Hollis Adams

Add more days with Hollis Adams

Return to Hollis Adams

Attend a Hollis Adams Cohort

Other

(Note: This information will not be used in the assessment of need for financial aid awards.)

Tell us about why you're applying!(Required)

I've had a change in financial situation.

I've had a significant unexpected expense.

I'd like to participate at Hollis Adams but cannot afford the cost.

Please share any information about your financial situation that will be helpful to us:(Required)

Please share any helpful information about your unexpected expense:(Required)

Please share what you hope to gain by receiving financial assistance from Hollis Adams:(Required)

Please share your approximate annual income (individual):

Please share approximate household income (if married or dependent):

Do you pay rent?(Required)

Yes

No

How much do you pay in rent monthly?

Do you receive any supplemental financial support (Medicaid, Medicare, ARC trust, family)?(Required)

Yes

No

Which of the following do you receive?(Required)

Medicaid Waiver

Medicare / Social Security

Rent Assistance

Food Stamps

Trust

Please indicate which Medicaid waiver(s)?

CIH

FSW

TBI

Other

Medicare / Social Security: Total Monthly Amount

Medicaid: Total Monthly Amount

Rent Assistance: Monthly Amount(Required)

Food Stamps: Monthly Amount

Special Needs Trust (SNT) Income: Monthly Amount

Anything else you'd like to share with Hollis Adams?

I agree that the above information is accurate to the best of my knowledge.(Required)

Confirm

I agree that the above information is accurate to the best of my knowledge.

Submitted by:(Required)

First Last

Δ

Financial Aid Request

Applicant's Name

First Last

Applicant's Phone

Applicant's Email

Applicant's Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

I am requesting support in order to:

Continue participating with Hollis Adams

Add more days with Hollis Adams

Return to Hollis Adams

Attend a Hollis Adams Cohort

Other

(Note: This information will not be used in the assessment of need for financial aid awards.)

Tell us about why you're applying!(Required)

I've had a change in financial situation.

I've had a significant unexpected expense.

I'd like to participate at Hollis Adams but cannot afford the cost.

Please share any information about your financial situation that will be helpful to us:(Required)

Please share any helpful information about your unexpected expense:(Required)

Please share what you hope to gain by receiving financial assistance from Hollis Adams:(Required)

Please share your approximate annual income (individual):

Please share approximate household income (if married or dependent):

Do you pay rent?(Required)

Yes

No

How much do you pay in rent monthly?

Do you receive any supplemental financial support (Medicaid, Medicare, ARC trust, family)?(Required)

Yes

No

Which of the following do you receive?(Required)

Medicaid Waiver

Medicare / Social Security

Rent Assistance

Food Stamps

Trust

Please indicate which Medicaid waiver(s)?

CIH

FSW

TBI

Other

Medicare / Social Security: Total Monthly Amount

Medicaid: Total Monthly Amount

Rent Assistance: Monthly Amount(Required)

Food Stamps: Monthly Amount

Special Needs Trust (SNT) Income: Monthly Amount

Anything else you'd like to share with Hollis Adams?

I agree that the above information is accurate to the best of my knowledge.(Required)

Confirm

I agree that the above information is accurate to the best of my knowledge.

Submitted by:(Required)

First Last

Δ

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ABOUT US

Hollis Adams (HA) is a privately funded nonprofit that has served adults with developmental disabilities for 50 years. We offer social, recreational, and community outreach opportunities through a wide variety of events and activities.