Global MIG Service Trip Mini-Grant Application
Name
First Name
Last Name
Credentials
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Current Employment or Educational Program
If a Student, please indicate degree sought through Program.
Undergraduate
Dietetic Intern
Graduate Student
Proposed Service Project Name
Location of Project
Date of Project Trip - must be on/after June 1
-
Month
-
Day
Year
Start Date
-
Month
-
Day
Year
End Date
List the Coordinating Organization(s) and include their mission/vision statement (if available).
Description of Project
What will you contribute to this Project?
Anticipated Budget: Please provide an itemized list of actual/estimated costs.
Additional Sources of Funding
All grantees are expected to share their experience and knowledge gained during this trip with GMIG and the Academy. What ideas do you have for sharing with leadership and members?
How did you hear about this GMIG Mini-Grant?
CV/Resume
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