Prosthetic Limb Application | Standing With Hope

Home
- About
The Radio Show
Books/Music
Prosthetics
- Donate A Used Prosthetic Limb
- Prosthetic FAQ
Caregivers
- Caregiver’s Blog
Giving

Select Page

To apply for a prosthetic limb, please fill out this form.

First Name*
Last Name*
Email*
Phone Number*
Gender*
Age*
Mailing Address*
City*
State/Region*
Country*
Postal Code
Type of Amputation*
Shoe Size*
Side of body*
How did you lose your limb?*
Phone
This field is for validation purposes and should be left unchanged.

Standing With Hope, Inc.

PO BOX 250 McAllister,
MT 59740

If you love someone, you’ll be a caregiver. If you live long enough, you’ll need one. Through our caregiver outreach, we’re helping those who help.

Peter Rosenberger

Founder, Standing With Hope

Join Community

Join our mailing list to receive the latest news and updates from our team.

Success!

Name

Email

©2021 Standing With Hope, Inc.

"For the Wounded and Those Caring for Them."

When Standing With Hope founder (and double-amputee herself) Gracie Rosenberger shared with Wanda that she will walk again, the emotions for both women were overwhelming.

Be a part of this …today!

Pin It on Pinterest

Share This

Facebook
Twitter
Google+
Pinterest
Delicious
LinkedIn
Myspace
StumbleUpon

Maintained By Arjun Kushwah