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The Gentry Foundation for Autism offers financial assistance to children who have no health insurance or who have benefits through Arizona state insurance (AHCCCS). The Gentry Foundation is funded through generous community charitable contributions. Scholarships are awarded to families for diagnostic evaluations and 1:1 support from a family liaison.

Qualifications are based on the family’s annual income, lack of private insurance and age of child (under 5 years of age). Please complete the enclosed application indicating why you think your child may be at-risk for Autism and in need of an Autism evaluation. Applications cannot be processed without verification of at least 2 months’ current income, or proof of AHCCCS coverage. This could be copies of 2 months of paystubs or bank statements. If submitting bank statements please highlight the payroll deposits. If both parents are employed please include information for each.

Please allow 1-2 weeks for processing and approval. Your application will be reviewed by the Scholarship Committee, and we will contact you with their determination.

The Gentry Foundation for Autism Scholarship Application

Please complete and submit this application.

Once application is submitted, verify financial need by emailing ONE of the following to [email protected].

1. Proof of current AHCCCS/Medicaid/HUD enrollment
2. Copies of 2 months’ pay stubs.
3. Copies of 2 months’ bank statements for employees with payroll direct deposit—please highlight/circle payroll deposits.

*If both parents are employed, please include information for each.

Dear Families,

The Gentry Foundation for Autism Scholarship Application