If you believe you or someone you know are being limited physically, mentally or socially by something in society, fill out the application below to begin the process of rectifying it for your self or for others.

This initial application is to help familiarize The Foundation and Ministry of L.I.F.E. with the scope of the limitation in terms of who it affects and how it affects them. Based on this initial application a Foundation or Ministry Representative will contact you with the next step.

Thank you!

Foundation and Ministry of L.I.F.E. Staff

Apply Online

*Date

*Last Name

*Middle Name

*First Name

*Age

*City

*State

*Country

*Telephone Number

*Email Address

*Describe the limitation you experience and explain why rectifying it is important to you and others

*Describe the location of the limitation you have described

*What is your solution to the limitation?

*What resources do you believe it will take to rectify this limitation?

*Upload any other materials that you believe we need to make a decision to offer you assistance?

Fields with (*) are compulsory.