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The Stork Fund Application

Please note – all applicants must live within 60 miles of 15901

The Stork Fund Application

The Stork Fund, under the umbrella of Community Foundation for the Alleghenies, provides financial support for infertility treatments or adoption fees for individuals in the Greater Johnstown region who have experienced fertility issues or miscarriage. Questions about this application can be directed to Victoria Kimmel at vkimmel@cfalleghenies.org.

Address(Required)
Do You Have Any Children? Choose the best answer to describe your family.(Required)
Type of Assistance Requested(Required)

Max. file size: 1 GB.
Billing Address(Required)
Patient's Full Name(Required)
MM slash DD slash YYYY
This helps the committee better understand your needs to determine eligibility.
This helps the committee better understand your needs to determine eligibility.
Would you be willing to publicly share how Stork Fund helped you?(Required)

By submitting this application, the undersigned hereby acknowledges the information provided on this application, including attachments, is true and correct to the best of his/her knowledge, and the information may be provided and disclosed to the Community Foundation for the Alleghenies and to any other person(s) authorized by the Foundation to review the information. Verification of what is presented in this application may be obtained from any source. Signing below hereby releases from liability any person(s) submitting information to the Foundation for use in the selection of award recipients. By selecting ' Yes' to the box below I am agreeing to the above terms.(Required)

Here for our community, for always.

Main Office

COMMUNITY FOUNDATION
FOR THE ALLEGHENIES

216 Franklin Street, Suite 400
Johnstown, PA 15901

(814) 536-7741
info@cfalleghenies.org

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