Guidelines for Assistance

(assistance MUST be for medically related needs)

• ASSISTANCE REQUEST MUST BE FILLED OUT BY SOMEONE OTHER THAN THE RECIPIENT, REQUESTER (PERSON FILLING OUT THE FORM) MUST BE A MEDICAL PROFESSIONAL, FRIEND OR CLOSE FAMILY MEMBER AND MUST BE LIVING OUTSIDE OF THE RECIPIENTS HOUSEHOLD.

• ASSISTANCE IS NOT GUARANTEED AND IS DEPENDENT ON AVAILABLE FUNDS AND BOARD APPROVAL.

• ASSISTANCE REQUEST MUST BE DIRECTLY RELATED TO RECEIVING MEDICAL CARE

• ASSISTANCE IS LIMITED TO ONE TIME A MONTH OR 30 DAYS.

• THE TRAVIS BURKHART FOUNDATION DOES NOT PROVIDE ASSISTANCE FOR DAY TO DAY LIVING EXPENSES.

• WHEN REDEEMING GAS CERTIFICATES THE RECIPIENT MUST BE PRESENT, IN SOME CASES ID MAY BE REQUIRED.

• TBF IS NOT RESPONSIBLE FOR REPLACING LOST OR STOLEN ASSISTANCE CARDS/CERTIFICATES.

• ASSISTANCE GIVEN MUST BE HONORED RESPONSIBLY AND USED FOR THE SOLE PURPOSE THAT IS INTENDED.

• ANY MISUSE OF ASSISTANCE COULD ADVERSELY AFFECT FUTURE ASSISTANCE.

• REQUESTS FOR A iPAD REQUIRE A LETTER OF RECOMMENDATION FROM A MEDICAL PROFESSIONAL

• ASSISTANCE COULD BE AFFECTED IF THERE IS AN ACTIVE GO FUND ME ACCOUNT

• INFORMATION PROVIDED MUST BE DETAILED AND THOROUGH

• MUST BE A LEGAL UNITED STATES CITIZEN