Caring Foundation Funding Applications

Complete the form below to apply for funding

CaringforKids
CaringforCommunities
Other Charitable Giving Requests

After you submit an application, if there is additional information you would like to share, please email all attachments to caringfoundation@bcbsnd.com.

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*Indicates Required Fields

Is your organization a 501 (c)(3)?*

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Will any of these funds be used for any of the following activities?*

Lobbying
Conducting voter registration drives or influencing a public election
Grants to individuals
Non-charitable purpose

If funds will be used for any of these purposes, you do not qualify to apply for any BCBSND Caring Foundation grant funding

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Thank you for inquiring about BCBSND Caring Foundation funding. Unfortunately, your request is ineligible to receive funds from the BCBSND Caring Foundation.

Name of Organization*

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Employer Identification Number (EIN)

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Address*

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City*

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State*

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Zip Code*

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First Name*

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Last Name*

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Job Title*

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Email*

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Phone*

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Organization Website

Organization Mission*

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List all services provided by organization

PROPOSAL INFORMATION

Please give a 3-5 sentence summary of funding request *

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Key Project Dates*

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Estimated number of people impacted*

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Gender Served (choose all that apply) Male Female

Ethnicity Supported (choose all that apply) White Hispanic or Latino Black or African American Native American or American Indian Other Ethnicity

Specify Other Ethnicity:*

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Age Served (choose all that apply) Children (12 and under) Teens (13-19) Adults (20-64) Senior Citizens (65+)

BUDGET

Dollar amount requested from BCBSND Caring Foundation* $

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Total projected project expense (for support other than general operating)* $

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Total annual organization budget $

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List other partners on this project

List other additional sources of funding for the project and include the status of all funding requests

Please select the grant funding period for this request: *

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GRANT PROPOSAL NARRATIVE

Please provide the following information in the order presented below.

PROJECT DESCRIPTION

Describe your proposed project. Include (i) the purpose and goals of your project, and the capacity to carry out the project; (ii) the statement of need for your project; (iii) the population served by the project, and the location of those individuals; and (iv) the way in which you will measure the success of your project.*

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PROJECT PLAN

Describe the strategy and timeline to be used in the development and implementation of your project. *

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Describe the evaluation process for your project, including expected outcomes. Outline (i) the evaluation process, (ii) the individuals responsible for measuring and reporting the outcome of the project, and (iii) a description of how the project will be funded and sustained in future years. *

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Thank you for the work you do with North Dakotans and your application for BCBSND Caring Foundation funding. Your grant application has been received. Caring Foundation will be in touch with you after your application is reviewed.

DISCLAIMER CONTENT
By submitting this application, you certify that the information provided in this grant application is accurate and complete to the best of you ability and knowledge. You further acknowledge that is awarded a grant from BCBSND Caring Foundation, you will provide grant project pictures, two evaluation reports and one certification to BCBSND Caring Foundation that the funds have used used for the purposes stated and within the time specified in the grant application.

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PROPOSAL INFORMATION

BUDGET

GRANT PROPOSAL NARRATIVE

PROJECT DESCRIPTION

PROJECT PLAN