Nursing Placement Foundation

Grant Application

Thank you for taking the time to submit an application for The Nursing Placement Foundation to consider a grant.

We offer grants to Organizations and Individuals. Please choose Organization Application or Individual Application (below).

Guidelines
1. Grant awards are up to a maximum of $5000.
2. Applicants should conduct their own research to determine the Foundations that award grants to your type of organization, for your field of interest and your geographic location.
3. Please answer all questions within the application.
4. In the section marked 'Organization's Proposed Use of Grant Award', please provide a detailed description of the following:
  1. Dollar Amount Requested
  2. Type of services provided by your organization
  3. Approximate number of individuals who will be served through receipt of the grant
  4. Itemized breakdown of how funds will be allocated
5. You are required to submit the following documents with your organization application:
  1. 501(C)(3) Certificate
  2. Most recent tax returns or 990-N
6. Please DO NOT include any other materials or information other than those specifically requested.
Date Submitted
Recipient Organization
Organization's Legal Name*
Doing Business As*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Fax*
Hidden
Organization's Website hidden
PLEASE use a full URL including "http://". Example "http://abc.com"
Organization's Website
EIN Number*
Organization’s Tax Exempt IRS Code Section*
Please upload your 501(C)(3) Certificate*
Allowed file types: pdf, jpg, png, doc, docx
Drop files here or

Accepted file types: pdf, jpg, png, doc, docx, Max. file size: 50 MB.
Please upload your most recent tax returns or 990-N*
Allowed file types: pdf, jpg, png, doc, docx
Drop files here or

Accepted file types: pdf, jpg, png, doc, docx, Max. file size: 50 MB.
Organization’s Proposed Use of Grant Award
Dollar Amount Requested*
Please enter a number less than or equal to 5000.
Number of individuals who will be served by this grant*
Type of services provided by your organization*
Itemized breakdown of how funds will be allocated*
Organizations' Contact Info
Name of Executive Director/CEO*
First Last
Email of Executive Director/CEO*
Name of Main Contact for Grant Proposal*
First Last
Phone of Main Contact*
Email of Main Contact*
Submitted By
Please enter your contact information.
Your Name*
First Last
Your Email*
Your Phone*
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Date Submitted
Grant Recipient Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Social Security Number*
Email*
Home Phone*
If you do not have a home phone please enter all zeros.
Cell Phone*
If you do not have a cell phone please enter all zeros.
Main Contact
Please enter an individuals' name to use as a 'Main Contact'.
Name*
First Last
Email*
Phone*
If you do not have a home phone please enter all zeros.
Cell Phone*
If you do not have a cell phone please enter all zeros.
Dollar Amount Requested*
Please enter a number less than or equal to 5000.
Maximum grant is $5000.
Applicant’s Proposed Use of Grant*

Please provide as much detail as possible.
Submitted By
Please enter your contact information.
Your Name*
First Last
Your Email*
Submitted on Behalf of*
First Last
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Nursing Placement Foundation

Grant Application

Guidelines

Recipient Organization

Organization’s Proposed Use of Grant Award

Organizations' Contact Info

Submitted By

Grant Recipient Information

Main Contact

Submitted By

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