01
Applicant
Download the scholarship application to your computer. Open it, type your answers into it, sign it, and save it.
ApplicantScholarship application
Apply for a scholarship.
We help men with a substance use disorder attend high-quality extended care treatment they could not otherwise afford. Scholarships are paid directly to the treatment program, never to the applicant or his family.
Who can apply
- Men age 18 or older with a substance use disorder
- Recommended for extended care by a licensed clinician
- Unable to cover the full cost of treatment after insurance and family resources
02
Clinician
Your clinician, therapist, physician, or interventionist downloads the Clinical Recommendation, fills it out, and submits it to us directly. Send them this page.
Clinician03
Submit
Once your form is filled out and saved, come back to this page and press Submit to email it to the Foundation.
If you are in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911. Do not wait for a scholarship decision to get help.
Before you apply
What to send with your application
- A government-issued photo ID
- Proof of income: your most recent tax return, 2 recent pay stubs, or a benefits letter
- Insurance card (front and back) and any approval or denial letter, if insured
- A program cost estimate or admission letter, if you have one
Attach them to the same email as your application. Copies or clear phone photos are fine.
What happens next
- Within 2 business days, you will receive an email confirming receipt, your application ID number, and anything that is missing.
- Once your application is complete, our board of directors reviews it at its next meeting.
- You will be notified of the decision in writing within 3 business days of the vote.
Your privacy
Your application is confidential. It is reviewed only by the Foundation's board of directors and is identified by an ID number, not your name. We do not share your information with anyone outside the Foundation except the treatment program, and only as you authorize in the application.