Clone of COLLECTIVE COMMUNITY CARE GRANT (CCG) REQUEST FORM (Eng and Span)
  • Childbirth Collective Community Care Grant (CCG) Request Form

    Phase Two: Services Provided January 1 - April 30, 2026
  • Welcome, and thank you for your interest in a Childbirth Collective Community Care Grant! Please read our CCG Info Page, which includes important eligibility details and FAQs.

    Note:
    While our Pilot Cycle earlier this year was limited to birth and postpartum doulas, this cycle expands eligibility to include a broader range of perinatal professionals. We’re excited to widen the circle and support more members of our community!

    This grant program is designed to serve Minnesota families by sustaining pro bono (free) or deeply discounted perinatal support with a focus on dignity, resilience, and partnership across communities. It is funded by generous community donors!

    Everyone who meets the eligibility criteria described on our CCG Info Page and on page 3 of this form is welcome to submit a request for funding! The Childbirth Collective honors the leadership of BIPOC and multilingual caregivers who have long carried birthwork forward, and we especially encourage those coming from historically marginalized populations to submit a grant request.

  • Phase Two Funding Cycle

    • Your Pro Bono/Deeply Discounted Services Were Rendered:
      January 1 - April 30, 2026

    • Request Form Available:
      May 15 - May 25, 2026

    • Grant Amount:
      Individuals self-select a grant request amount of either $250, $500, $750 or $1,000 each cycle. Grants are not guaranteed, and will be allocated through a lottery process when requests exceed funds available within a cycle. Individuals may submit one request each funding cycle, with an annual maximum of $1,000 per recipient.
       
    • Grant Disbursement to Approved Requestors:
      Mid-June
  • Grant Requestor Information

  • Grant Requestor Eligibility

  • Attestation to Eligibility

    Affirm and attest that you meet all of the following eligibility criteria by checking the box below.

    • You are a perinatal professional who provided pro bono or deeply discounted services in Minnesota during this funding cycle (January 1 - April 30, 2026).

    • You served pregnant, birthing, and/or postpartum individuals in Minnesota who face barriers to access related to recent federal enforcement actions in the state.

    • You have experienced indirect or out of pocket costs or capacity strain associated with this work. Examples include, but are not limited to:
      • Transportation and travel
      • Supplies, equipment, or materials used in care
      • Childcare or family care costs incurred while providing care
      • Administrative, communication, or coordination costs
      • Lost billable opportunities
      • General resource strain
  • *If you are unable to affirm and attest to all of the above, please email info@childbirthcollective.org for potential future grant funding.

  • Additional Information

  • In compliance with our 501c3 status, we must be able to demonstrate that the funds we grant to individuals ultimately furthers the public good rather than private, individual benefit.

    Your answers to the questions below will be aggregated with other applicants' to demonstrate the public good purpose of this grant program. Your individual answers will be kept securely in our encrypted application system, and they won't be shared with any outside parties for any reason.

    Your answers below do not impact funding selection.

  • What pro bono or discounted service(s) have you provided during this funding cycle (January 1 - April 30, 2026)?*
  • Select all area(s) where you are experiencing financial impact or capacity strain while providing this community care:*
  • Requestor Attestation & Signature

  • I attest that all information provided in this request form is true, and that any/all grant funds awarded will be used in alignment with the purpose of offsetting the out-of-pocket and indirect costs associated with providing pro bono or deeply-discounted community perinatal support.

    I understand that this grant is designed to contribute toward the sustainability of my pro bono or discounted services and does not constitute a contract for services, wages, or payment for labor. As such, no employer-employee or agency relationship is inferred.

    I recognize that grants are taxable income, and I understand that it is my responsibility to seek information on my personal reporting requirements.

  • Date:*
     - -
  • Grant Disbursement Details

  • If approved for a CCG, select your preferred payment disbursement method:*
  • Thank you for requesting a CCG! You will be notified if you will receive grant funds via email by 6/1/2026. Questions? Please contact: info@childbirthcollective.org

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