Clone of AAIMM Village Fund 2024 Grant Application

AAIMM Village Fund 2025

IMPORTANT NOTES: Be sure to work on your grant application offline before entering the answers into the portal. You will have the opportunity to save your grant application as a draft in the portal. For your application to be considered, all required attachments must be submitted in PDF format.
Primary Contact Person for the Grant
Name*

First NameLast Name
Title*
Phone #*
Email*

Confirmation Emailexample@example.com

Section 1: Applicant’s Information
Category (choose one)*

Nonprofit organization, network, or coalitionIndividual service provider, micro-enterprise, or small businesses
Legal name of organization, business, network, coalition, etc.*
Fiscal Sponsor (if applicable)
Street Address
If fiscally sponsored, please list the fiscal sponsor’s address.
City
If fiscally sponsored, please list the fiscal sponsor’s city.
State
If fiscally sponsored, please list the fiscal sponsor’s state.
Zip
If fiscally sponsored, please list the fiscal sponsor’s zip.
Name of highest-ranking staff member, business owner, or person performing the service.*

First NameLast Name
Title of highest-ranking staff member, business owner, or person performing the service.*
For example, Executive Director, Owner, CFO, etc.
Email of highest-ranking staff member, business owner, or person performing the service.*
example@example.com
Phone number of highest-ranking staff member, business owner, or person performing the service.
Is the highest-ranking staff member, business owner, or person performing the service Black?*

YesNo
Year Established/Launched*
Website or social media handle (if applicable)

Section 2: Proposed Work
Please choose the primary strategy that best describes your proposed work.*

Supporting the physical, emotional, and mental well-being of Black women/birthing persons, fathers, partners, and families before, during, or after birth by providing respite care; fostering a positive sense of self; increasing access to healthy and joyous births.Testing new ideas and/or contributing new discoveries, lessons, or information to the body of knowledge around Black infant and maternal health.Promoting community education and/or engagement through program services.Promoting community engagement, partnership, and advocacy.
Please describe the broad goals of your work. In your description, include your service or mission, geographic communities served (i.e., Pasadena/Altadena, South LA, Van Nuys, etc.), and demographic communities served (i.e., Black fathers, Black mothers generally, Black mothers experiencing postpartum stress, etc.).*

Your description above should be written for the entity performing the funded work, not the fiscal sponsor. (150 words)0/150
Provide a brief description of your project. What do you plan to do, and what results will you achieve? Please include the number of Black people and/or families you plan to serve.*

150 words0/150
How does the work you do address the high rates of Black infant and maternal mortality in LA County? If you are not sure, that’s okay. Please say how it might help to address the problem.*

250 words0/250
How do you recognize and support Black women on your staff or in community as leaders and experts in infant and maternal health? If you are new to the infant and maternal health field, please describe how your work empowers the voices and leadership of Black women.*

500 words0/500
How is your work unique/impactful or how does it meet a specific need with Black families experiencing pregnancy or childbirth? Why do you believe this work is important to help increase joyous and healthy births for Black moms and babies?*

500 words0/500
Describe how you will implement the project and how you will use the funds to implement your proposed work. Please include staffing for the proposed project and their experience with conducting the specific work proposed as part of the project.*

250 words0/250
Please name any organizations or businesses you plan to collaborate or work with on this project. If you are not sure, that’s okay. Please tell us who you currently partner with within the community. *

150 words0/150
What is the most difficult aspect of this project that could affect your success? *

150 words0/150
What do you (or your organization) hope to gain from participating in the AAIMM Ambassadors (Learning Community)? What do you hope to contribute?*

250 words0/250
Can your proposed work be billed to MediCal or another health insurer (or paid for with other existing resources)? If you are unsure, please ask us.*

YesNo
If you answered yes to the above question, please describe why you believe this project should be considered for funding by The Village Fund. If you answered no, please proceed to the next question.

150 words0/150

Fiscal Sponsorship

Individual service providers, micro-enterprises, or small businesses will need to apply using a fiscal sponsor.
Fiscal sponsor: Fiscal sponsorship is an arrangement between a non-profit organization with 501(c)(3) tax-exempt status and a project conducted by an organization, group, or an individual that does not have 501(c)(3) status. Fiscal sponsorship permits the exempt sponsor to accept funds restricted for the sponsored project on the project’s behalf. The sponsor, in turn, accepts the responsibility to ensure the funds are properly spent to achieve the project’s goals. (Definition provided by CharityLawyerBlog.com)

The California Black Women’s Health Project has agreed to serve as a fiscal sponsor for The Village Fund. If you do not already have a fiscal sponsor and are interested in seeking fiscal sponsorship, please complete this page.
Do you need a fiscal sponsor?*

YesNo
If you are currently applying for fiscal sponsorship, please add any comments here. You may also use this space for any questions about seeking fiscal sponsorship.
For example, the name of the fiscal sponsor you seek to work with, where you are in the process, or any questions you have for The Village Fund team.

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Project budget

Please upload the budget as a PDF with all relevant columns and rows visible.
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Your organization's W9 or IRS letter of determination

If you are a nonprofit, please upload your organization's W-9 or IRS letter of determination. If you have a fiscal sponsor, please send in their W-9 or IRS letter. Individual service providers, micro-enterprises, or small businesses do not need to send a W-9. If chosen to receive a Village Fund grant, you will be given instructions on setting up fiscal sponsorship with the California Black Women's Health Project.
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Should be Empty:

AAIMM Village Fund 2025

Primary Contact Person for the Grant

Section 1: Applicant’s Information

Section 2: Proposed Work

Fiscal Sponsorship

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