Health New England's DEIB Mini Grant Submission Form
Due Midnight on Monday, August 2, 2021
Street Address Line 2
State / Province
Postal / Zip Code
Point of Contact Full Name
Point of Contact Title
Point of Contact Email
Point of Contact Phone Number
Please enter a valid phone number.
DEIB Grant Program Focus Areas:
Organizations can receive up to $7,500 for programs that address food insecurity.
Organizations can receive up to $7,500 for programs that address gender identity and sexual orientation.
Organizations can receive up to $2,500 for supporting paid internships for emerging youth leaders (high school and college students).
Dollar Amount Being Requested
Up to $7,500
Please describe the program or initiative you will be implementing that addresses one of the DEIB focus areas:
Priority Population your program will serve.
Communities of Color (BIPOC)
Racial and ethnic minority groups
Immigrant and Refugee
Justice Involved Individuals
Estimate Reach / Anticipated Number of Lives Program will Touch
Describe how you will evaluate the success of the program or initiative. Include a description of what success will look like.
At least one goal.
Geographic Area Served (choose all that apply)
Social Determinants of Health (SDOH) Focus
Built Environment - access to healthy food, transportation, access to parks/open space
Education - higher education, language and literacy, early childhood education and development
Employment - economic stability, poverty,
Housing - physical conditions within homes, housing affordability, homeless
Social environment - social isolation, interpersonal and structural racism
Violence and trauma
Are you currently a Health New England employer group?
Should be Empty: