Apply

Last applications to be accepted will have to be submitted by June 30, 2026

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

    "To pay for the operation out of my own pocket would have made a serious impact on my year's finances and therefore climbing, skiing, and working plans. The Kees Brenninkmeyer Foundation made it much easier for me to make the decision to get the metal removed early and therefore reduce damage and implications on my knee and hip from skiing and climbing for longer with the metal still in. I can't thank the foundation enough!"

    - William Sim

    Read More