Equipment Grants Application

Equipment Grants Application

SHM Global and Rural Health Foundation
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What is your role in hospital medicine?*
Name of sponsoring not-for-profit *
Sponsoring not-for-profit URL*
Letter of Institutional Support*

Please upload a signed letter of institutional support for the purchase from a member of the not-for-profit leadership (e.g. hospital or health system leadership).
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Please provide a brief personal statement, in 500 words or less, articulating:

a.

The underlying need and target population; and,

b.

Goals and anticipated outcomes of equipment grant in addition to how they relate to the mission of the SHM Global and Rural Health Foundation.
Personal Statement*
Brief description and estimated cost of equipment*
Desired date of purchase (must be in future)*

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Curriculum Vitae*

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