Apply

Please complete the following fields to request an application. Thank you for your interest in the Kees Brenninkmeyer Foundation.

Name

Email

Phone Number

Mailing Address










Street Address











Injury Description

Have you seen a physician regarding this injury?

Career Type

Career Description

Medical Insurance

Do you have or anticipate future access to crowd funding or other fundraising platforms?

How were you informed about the foundation?

Please verify the following image

captcha

Featured Testimonial

"Although I have personal health insurance, the out of pocket expenses, time away from guiding and level of physical therapy I needed created quite a financial burden. With the help of the KBF, I was able to focus on my recovery and not worry about the financials as much. I am extremely lucky to have a very experienced and talented Certified Hand Therapist in my town (and she’s a climber!) who continues to help me regain my strength and mobility in my hand. Without the KBF I would have been limited to much less PT than what I need to regain strength and mobility and get back to my guiding. "

- Steve Banks

Read More