Community Giving Fund Grant Application
Full name of the person filling out this form and title/role at Aspire:
Email address of the person filling out this form:
Full name of the individual or name of the program that this grant will benefit:
State where the individual or program resides:
Connecticut
Maryland
Massachusetts
New Hampshire
Vermont
Other
Amount of money you are requesting:
Please describe your request and explain how this grant will make an impact for the person or people that will benefit from it:
Who generated this idea?
Individual supported
Staff
Individual supported family member
Provider
Other
How was the idea generated:
Emerging practice in the field
During a planning meeting (IEP, SP, etc)
Major life event (wedding, family event, vacation, emergency situation)
Discussion with parent/family member, funder
Individual supported requested it
Long term goal of person supported
New opportunity available
Other
In an effort to take a person-centered approach in our work at Aspire, please explain how those who would benefit from this grant were involved in making this request? If the individual(s) were not involved in making this request, please explain why:
When is the money needed:
Immediately - as soon as possible
Within one month of request
Within 2-3 months of request
Within 3-6 months of request
No specific timeline
Please explain the timeline:
Have you worked with a supervisor or other colleagues to address this need using the regular Aspire program budget for this expense:
Yes
No
If no, would you be interested in learning more about how to build requests for programs and individuals into your departments budget:
Yes
No
Maybe
If your grant is awarded, you will be required to sign a contract stating that the grant money issued will be used for the purpose outlined in this application. If you would like to change the purpose of this grant, you must request that the committee review and approve the change. Any monies not spent within 1 year of date issued, must be returned to the Community Giving Fund. Do you agree to sign the contract:
Yes
No
Submit
Should be Empty:
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