LDA FOUNDATION DISASTER GRANT APPLICATION


GRANT APPLICATION FOR LOUISIANA DENTISTS AFFECTED BY DISASTER
(for property damage only)

Application deadline: The end of the period of time in which a State of Emergency related to the disaster is declared to be in effect by the state of Louisiana.

This online application will be submitted automatically once you complete all pages.
Fax additional documentation to 225-926-1886 or e-mail to tisha@ladental.org

Note: Documentation should include a maximum of 3 photos (email is acceptable). Photos can be emailed to tisha@ladental.org. Documentation CAN include an adjustor’s report, a detailed description of the items damaged/lost/destroyed or a combination. Grants are based on financial availability of funds through the LDA Foundation.


 

Pleases provide your temporary contact information:

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Links with this symbol are password protected for LDA members only.
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5637 Bankers Ave.
Baton Rouge, LA 70808
(225) 926-1986  |  (800) 388-6642
(225) 926-1886  Fax
info@ladental.org

Links with this symbol are password protected for LDA members only.
5637 Bankers Ave.
Baton Rouge, LA 70808
(225) 926-1986  |  (800) 388-6642
 Fax (225) 926-1886
info@ladental.org