Please fill out the form below with your contact information, a short paragraph outlining your story and desired need. Someone will be in touch with you shortly. For more information and to review the terms of grant eligibility visit: Criteria for Applicants.

Samantha Remington Angel Heart Foundation Consent to Use Photo, Story, and Name for Promotional Purposes. Please complete this form to indicate your consent for the Foundation to share your story and/or photo.

The Samantha Remington Angel Heart Foundation is honored to support your journey through our grant program. To inspire others and show the impact of our work, we often share grant recipients’ stories and photos on our website, social media, newsletters, and other promotional materials.

By signing below, you give permission to the Samantha Remington Angel Heart Foundation to use the following for promotional and educational purposes: - Your first name (last name optional or omitted, depending on preference) - Your story or testimonial related to your experience receiving the grant - Photographs or videos of you (optional – you may choose not to include an image) This information may be used in: - The Foundation website - Social media posts - Donor or sponsor reports - Print materials (brochures, flyers, newsletters, etc.) You may review any materials upon request before they are published.