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Friends of JCDS Friends of JCDS
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Special Assistance Application

Please fill out the form below to find out if you qualify for special assistance or
please contact us with questions. Thank you.

Special Assistance Application

Step 1 of 2

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  • Thank you for your inquiry. Based on your response, it does not appear that your request would qualify for Special Assistance Funding from Friends of JCDS. Currently, all requests for Special Assistance must be made by an individual or their representative that receive at least one of the following: Targeted Case Management, Day/Employment Services or Residential Services from Johnson County Developmental Supports.
  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • Max. file size: 50 MB.
  • Financial resources of individual(s):

    Additional documentation would help to facilitate our review. Please provide additional documentation to support request, such as copies of leases, recent copies of client obligation, etc.)

  • Friends of JCDS Special Assistance Request Budget Form

  • Monthly Income

  • Monthly Expenses

  • Please complete form in its entirety. Friends of JCDS, Inc. may have additional questions regarding this application and should you be contacted, please respond promptly. Requests for additional information that are not responded to within 2 business days will result in denial of the request. Individuals must receive services from Johnson County Developmental Supports in order to qualify for support from Friends of JCDS, Inc.

Friends of JCDS
913.826.2270
10501 lackman road lenexa, KS 66219
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