Wild Med 21-Day Grant Partnership Inquiry

Wild Med 21-Day Challenge Partnership Grant Application

Thanks so much for your interest in our 21-Day Challenge Partnership Grant to raise money for your organization! We are so proud to have raised tens of thousands of dollars for organizations across the country! Please view the public-facing 21-Day Challenge page for more information.
Email address:
Your first and last name:
Name of organization:
Your role or position:
Mission of organization:
Geographic location served:
How many people are on the email list?
How many people follow the organization on Facebook?
How many people follow the organization on Instagram?
How do you intend to use the funds? We find that organizations with a specific use in mind (i.e. scholarship fund, staff training, purchase land or equipment) are vastly more successful.
What month would you prefer to participate? We are often booking 3-6 months in advance. (Please consider other marketing, fundraising asks, etc that you will be doing so you don't exhaust your audience.)
What email marketing service provider does the organization use?

MailchimpInfusionsoftConstant ContactFlodeskActive CampaignNone, we just send marketing directly from our emailOther
Are you willing to send 4 emails to your audience in the 2 weeks prior to the start of the course? Please note, this is a requirement.

Yes, definitely!No, this won't work for us.
Should be Empty:

Wild Med 21-Day Challenge Partnership Grant Application