LDA FOUNDATION DISASTER GRANT APPLICATION


7833 Office Park Blvd., Baton Rouge, LA 70809

www.ladental.org

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 4 pages.
Fax additional documentation to 225-926-1886 or E-mail to tisha@ladental.org



 

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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7833 Office Park Blvd.
Baton Rouge, LA 70809
(225) 926-1986  |  (800) 388-6642
(225) 926-1886  Fax
info@ladental.org

Links with this symbol are password protected for LDA members only.
7833 Office Park Blvd.
Baton Rouge, LA 70809
(225) 926-1986  |  (800) 388-6642
 Fax (225) 926-1886
info@ladental.org