Please choose one.
Reminder: You must be 18 years or older to apply.
Please provide us the link/URL to your Facebook profile. Example: http://Facebook.com/strongbill
Reminder: You must be 18 years or older to apply. If you are under 18 years old, please ask that your legal guardian or caretaker apply on your behalf.
We'll be sending all correspondence regarding this application to this email address.
This will be the main contact telephone number for this application.
If the Applicant is selected for an iPad grant, this is where the applicant's iPad will be sent.
Please upload a high resolution picture of the Applicant.
Please check all that apply.
This section is completely optional. But if there is anything further that you'd like to share with us, please have at it!
Please go to PMTermsAndConditions.com to review our Terms and Conditions before clicking "Agree". We'd also recommend printing a copy for your records.