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Join the Summer Match Challenge! All donations during the month of June will be matched by the Clementz-Peterson Family Fund and an anonymous donor, up to $100K. DONATE

Stipend Request Form

Fill out the form below completely. 

Payment can be made via ACH, check, or PayPal. ACH and PayPal are preferred, and will give you the fastest reimbursement. Checks are mailed through our BillPay service and will take 10-15 business days.

Any questions should be emailed to sue@ataxia.org.  Thank you!

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