Application

In order to have your loan request processed, you must submit a completed application packet to the following address.

Michigan Assistive Technology Loan Fund
c/o United Cerebral Palsy of Michigan
4970 Northwind Dr, Suite 102
East Lansing, MI 48823

You may download a PRINTER-FRIENDLY VERSION of this packet by clicking on one of the links below:

Download the consumers application packet in:

If you are unable to download one of the versions above, contact United Cerebral Palsy of Michigan at 1.800.828.2714 and an application will be sent to you via mail.

If you are an employee of on of the application sites and need to download a copy of the Program Qualification Certification form, please download a copy here.

Program Qualification Certification Form Word Icon Graphic WORD VERSION >>
Program Qualification Certification Form PDF Icon Graphic PDF VERSION >>

You must submit one of these forms each time you submit a loan application.