Apply For a Grant

An applicant must meet the following criteria:

Be tax-exempt under Section 501(c)(3) of the Internal Revenue Service Code or have a fiscal sponsor that has 501(c)(3) status and provides written authorization confirming its willingness to act as the fiscal sponsor.
Engage in work that aligns with the Foundation’s funding interests and priorities.

Please fill the Medserve Foundation Grant Application Form Below:

Phone
This field is for validation purposes and should be left unchanged.
Background Information
Program or project title*
Organization
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Fax
Email*
Website
Information about the Request
Date of application*
DD slash MM slash YYYY
Amount Requested*
Type of Support (please check):
- Project
- General Operating
- Capacity Building
- Technical Assistance
- Emergency
What geographic area will be served?*
Approx. number of people served?*
Time period covered by grant?*
Organizational Information
How long has the organization been in existence?*
Number of paid staff:
Full-time
Part-time
How often does your board meet?
IRS 501(c)(3) Determination Letter (Required for Consideration)*
Max. file size: 2 GB.
Financial Information
Total income of organization (most recent fiscal year)*
Total expenses of organization (most recent fiscal year)*
If project:
Total expenses budgeted for the project*
Amount raised for the project so far:*
Please list the other funding sources with the amount funded per source: **