Applications

Want to Modify Your Current Vehicle?

Apply HERE for aftermarket adaptations on currently owned vehicles.

Mobility Assistance Vehicle Request

Apply HERE to request the mobility assistance vehicle tailored to meet your needs.

Specialty Mobility Equipment Request

Apply HERE for specialty mobility equipment and accessories for your child’s home or school.

Application Process

  • Read the “Application Guidelines”. Scroll down to see qualifications.
  • Apply for specialty mobility assistance vehicle or equipment by selecting the appropriate application above.
  • Applicants will be chosen by the questions answered on the application including factors such as disability, financial need, ability to insure and maintain the vehicle.
  • Applicants will have several application steps throughout the process with MV4K.
  • Upon completion of the application process Applicants will be notified within 60 days if they have been chosen to receive an award (most of the awards are mobility vans or equipment depending on the family’s needs) from MV4K.
  • Recipients will sign and agree to Mobility Vans for Kids lease terms and agreements. Lease terms and agreements will vary based on the vehicle award and financial need.
  • Upon award, MV4K will schedule an appointment with MobilityWorks. The award recipient will then talk to a specialist (either in person or over the phone) that will help your family find the most suitable vehicle to fit your needs.
  • Upon vehicle selection, safety inspection, and all required documentation, MobilityWorks and MV4K will coordinate for vehicle pick up or delivery with the recipient (this timeframe will differ for each recipient and is subject to deadlines established between MobilityWorks and MV4K).
  • MV4K wants to help as many families as possible. The lease term will be 36 months (3 years). At the end of the three year term the child’s mobility and financial needs will be reassessed. The lease agreement will then either be renewed, modified, or terminated depending on said reassessment. During the lease term no adjustments to lease agreements will be made without notice or communication with recipients.

Application Guidelines

  1. The child recipient must be the age of 21 or under at the time of initial application.
  2. MV4K’s funds are limited. Applicants must demonstrate they have exhausted all state, federal, and other funding options to purchase a mobility assistance vehicle or other mobility equipment.
  3. Applicants must submit ALL application checklist items. This may include but is not limited to; contact information (name/address/phone/email), income verification, employment status (eligibility), citizenship status, marital status, veteran status, proof of insurance, proof of valid U.S. driver’s license, written statement, physician certification form (in accordance with HIPPA), and any other supporting documentation required. Partial, incomplete, or fraudulent applications will not be accepted.
  4. Awards are one van award per child. More than one household will require all adults 18 years or older living in all households to comply with the requested application items listed above in item #3.
  5. Applicants must hold and be able to show proof of a valid U.S. Driver’s License.
  6. At vehicle delivery, applicants are required to have an up to date insurance policy. Must be able to show proof of insurance.
  7. Applicants are subject to further interview should they be considered. Must be able to provide working phone number and email address. Any applicant that is not able to be reached for such further inquiries will no longer be considered.
  8. Applicants consent to all communications from Mobility Vans for Kids that include but are not limited to; phone calls, text messages, email notifications, and any and all written notifications.
  9. Applicants (if asked) must be willing to sign documents that could include but are not limited to; lease agreements, tax and title documentation, confidentiality agreements and non-disclosure agreements.
  10. Applicants have the right to provide, or not provide consent to the use or depiction of names, dates, media (photo/video), written statements or testimonials by Mobility Vans for Kids.
  11. Applicants must adhere to all guidelines as stated above in order to be qualified for an award from Mobility Vans for Kids.

Mobility Vans for Kids (MV4K) awards are not guaranteed and are subject to availability. Any and all awards are subject to termination at any time for any reason deemed necessary by Mobility Vans for Kids.