Please download, complete the application, and return it by fax or mail to the Idaho Assistive Technology Project for processing.
Use this version for printing a blank form to be filled out by hand.
Print Assistive Technology (AT) Finance Program Loan ApplicationPDF
Computer Fillable Form:
Complete by typing on your computer and then print. Use Firefox or Chrome browser to complete the form.
Note: This form will calculate the budget totals for you.
Fillable Assistive Technology (AT) Finance Program Loan ApplicationFillable PDF
For questions or assistance contact:
Krista Kramer - email@example.com / 208-885-6097 / 1-800-432-8324
Idaho Assistive Technology Finance Program
Attention: Krista Kramer
1187 Alturas Drive
Moscow, ID 83843
Toll Free: 1-800-432-8324