Request Funding 


Jillian's Jitterbug Foundation's goal is to supply as many families with the help they need.  We want to help your special needs child to become independent and mobile.  In order to request funding, print out the following form below and fill out the specified information.  If you are unable to print out an application, give us a call or send us an email and we would be more than happy to mail you a hard copy.  Once the form is completed, please mail it to the address listed below.  Once we receive your request form, we will review it and be in contact with you.


Because we want to be able to provide as many families as possible with financial assistance, a maximum amount of $500 will be alotted to each family within a 24 month period.  The amount given per family will be determined based on a case by case approval by our board of directors.   




8 Oak Forest Drive
Burlington, NJ 08016

Tel: (609)-792-7628


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Find us: 

190 Kings Ridge Court, Southern Pines NC 28387