Grant Application

Grant of Hope Application

Please complete the following Grant Application fields for consideration of a Grant of Hope from Fund a Life. Our grant committee carefully reviews each application on an individual basis, considering the unique circumstances and needs presented. While we strive to support as many applicants as possible, funding decisions are made based on the fit within our mission and resources available.
Recipient Name *

First NameLast Name
Date of Birth*
Is the grant recipient under the age of 18?*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
E-mail*
example@example.com
Grant Amount Requested *
ex. $5,000
What is the life-altering circumstance?*
Please list any other fundraising efforts made in support of this life event.*
How much has been raised? If none state N/A
References *
Please Include (3) references that our grant review team may contact when evaluating this application. If this is an medical related circumstance, please ensure at least one reference is a medical professional familiar with your circumstance should we need to contact them for verification purposes only. Include Name, Email, Phone and relationship of each reference.
Video Submission Request

We would love to get to know you better and understand the impact this Grant of Hope could have on your life. Please submit a short (3-5 min) video sharing your story with the following topics:

Your Story: Help us understand who you are and what has brought you to this moment.

The Obstacles You Are Facing: Share the challenges you experience and how they impact your life.

What a Grant from Fund a Life Would Do: Describe how this support would help you navigate these challenges or bring relief.

How This Grant Would Infuse Hope: Express what hope means to you and how receiving this grant could light the path forward.

Your video doesn't need to be polished. It's about honesty and heart. This is an opportunity to let our team truly see your resilience, your hope, and the difference this grant could make.

Click the button to record a video OR upload a previously recorded video below.

If you choose to record a video, click "Record Video" and select the "Camera Only" option so we see you and not your screen.

PLEASE NOTE: If no video is submitted, your application will not be counted.
Video Submission File Upload

Cancelof
If someone other than the grant recipient is completing this application, please provide your name, phone number, email, and your relationship to the recipient. If the grant recipient is under the age of 18, please also provide the guardian's information.*
Picture and Video Release - Fund a Life’s grant award stories are recognized as a beacon of hope for others desperately seeking it in times of crisis. These stories also inspire supporters to further impact our mission by sharing and celebrating the moments of hope our grant recipients experience. Capturing pictures and video throughout our grant award process is a powerful way to bring this impact to life whenever appropriate. By sharing a recipient's story, we have the opportunity to expand the gift of hope to more people. With this in mind, I understand that pictures and stories will be used to bring hope to families just like mine. If my grant is awarded, I give permission for Fund a Life to capture and use pictures and video to effectively showcase the impact of this award.*
By signing below I hereby acknowledge that I certify that the information I have provided on this application is complete and correct. I understand my failure to provide complete, accurate, and truthful information on the application will be grounds to be denied any funding opportunities and/or return any funding received*

Powered by Jotform SignClear
Should be Empty:

Grant of Hope Application

Video Submission Request