The Orange Butterfly Foundation:

Wings Program.

The Orange Butterfly Wings program is designed to provide financial assistance to individuals living with Traumatic Brain Injury (TBI). The program aims to alleviate the financial burden that often comes with TBI, and to provide support for individuals and their families as they navigate the recovery process. The program will provide funding for a range of expenses, including medical bills, therapy and rehabilitation costs, and other expenses related to TBI.

The application process for the Wings program is simple and straightforward. Interested individuals can apply for funding through our online portal, where they will be required to provide information about their individual circumstances and reasons for needing financial assistance. The application will also include a section for applicants to outline their specific funding needs and any other relevant information.

Apply Now

Applications for The Orange Butterfly Wings program are OPEN!!!!

Please fill out the application form below.

We are committed to helping individuals and families affected by TBI, and we look forward to reviewing your application. If you are or know someone who could benefit from this program, please do not hesitate to reach out to us.

New Wings Application

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Grant Recipient Details:

(Who is the grant for?)

Please indicate who the funding is for:

First Name

Last Name

Recipients Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Recipients Date of Birth

YYYY

Recipients Gender

Are you from Aboriginal or Torres Strait Islander decent?

Are you from a Non English Speaking Background?

Funding Details:

Briefly outline what the funding is for?

Total amount of funding amount sought from The Orange Butterfly

Do you currently receive NDIS Funding?

Have you applied for funding from any other foundation or source? If yes, please provide details:

Yes

Have you previously applied for funding from The Orange Butterfly? If yes, please provide details:

Yes

Briefly outline why this funding is important to yourself or the person applying for this funding:

What difference will it make?

Additional Information or supporting documents:

We strongly encourage you to provide the following information in support of your application.

Support letter from any of your consulting Doctors or Physicians:

Included YES/NO

If available, a copy of a Quote or Invoice for the required support.

Included YES/NO

Declaration and Signature:

I understand and acknowledge that this application will be used to consider my request for funding, but does not guarantee that my application will be assessed or that I will be offered funding. I declare and confirm that all the information I have provided to The Orange Butterfly Foundation in relation to this application is true and correct to the best of my knowledge. I give permission to The Orange Butterfly Foundation to contact any relevant person or organisation in order to verify the information provided in this application. I understand that an approval made on the basis of untrue or incorrect information may be revoked.

Yes

Wings Program: Collection Notice

Here at The Orange Butterfly Foundation we are committed to protecting your personal information provided by you.By clicking on the link to register for the Wings Program, you acknowledge that you have read, understood and consent to the terms of this collection notice.
We collect your personal information to register your interest in the Wings Program via an electronic form made available on our website (The Orange Butterfly’s website provider is Squarespace, click here to review their Privacy Policy https://www.squarespace.com/privacy ). We use this information to assess your request and to contact you regarding further details in regard to your request as well as the outcome of your application. We may collect personal and sensitive information i.e., names, gender, ethnicity, date of birth, postal address, residential address, email address, phone number and sensitive medical or health information from your consulting doctors or physicians in support of your application. Your personal data including your email address may also be added to our CRM Capsule (https://capsulecrm.com/privacy/ Capsule’s Privacy Policy) where you will be added to our mailing list, from which you may unsubscribe at any point.
We will not disclose your personal information without your consent, except where required to do so by law. Any sensitive medical or health information from your consulting doctors or physicians in support of your application will be saved against your unique profile within Capsule, a secure environment with restricted access.
You may contact us to request access to your personal information, or for other concerns regarding the privacy of your personal information by contacting Lauren Spear, CEO on email: lauren@theorangebutterfly.com.au
The Orange Butterfly Foundation’s Privacy Policy is currently under development and will be finalised in the coming weeks.

Contact us.

lauren@theorangebutterfly.com.au
Adelaide, Australia
If you need any assistance or have any questions about the application process, please do not hesitate to reach out to us.
lauren@theorangebutterfly.com.au
If you are a member of the press and have any questions or would like to learn more about the Orange Butterfly Wings program and its mission, please contact us at lauren@theorangebutterfly.com.au.
We are happy to provide additional information and answer any questions you may have.

Wings Program.

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