Grant Application

After completing the Cover Sheet Information form, please fill out the form below to complete your grant application.

Click here to complete the Grant Application Cover Sheet Form

Grant Application

2023 Grant Application

Have you completed the Grant Cover Sheet Information Form?

Yes

If you have not yet completed the Grant Cover Sheet Information form yet, please Click here to complete this form first

Contact Person

First

Last

Contact Email

Do you wish to apply for assistance with obtaining a Network for Good CRM donor database with this application?

If yes, please enter the approximate number of donor records/names to be imported into Network for Good.

We understand we will be responsible for assisting with the database implementation and for future maintenance.

Proposal Narrative

Organization Overview

Please provide your organizations information to include: number and composition of staff and volunteers and number of ambulances, carts, administrative vehicles, etc.

If you are requesting a piece of equipment or an ambulance, please provide a brief description:

(e.g. model, type) and quote of the item.

Required Attachments*

Current Organizational Budget
IRS 501 (c) (3) Determination Letter
Most recent annual financial report (audited or unaudited)**
Most recent IRS Form 990
Current Year Financial Statement
Board/Officers and Staff listings
Evidence of accreditation, licensing, etc. if applicable
Informational materials (e.g.: quote of the item being requested)
EMS MOU if you are requesting funds for an insurable asset

Please contact Gina Benefiel at gbenefiel@vbrescuefoundation.org to confirm which documents you need to submit or re-submit.

** A current report is still required for extended grant deadline.

Upload your attachments here.

Maximum upload size: 268.44MB