Grant Instructions

When submitting your Grant Application for the Community Health Initiative please follow these instructions, and review the list below carefully:

Read the Grant Guidelines, and sign acknowledgement form provided below which confirms your understanding that receipt of this application does not imply eligibility or approval and that all the information contained in the application is current and accurate to the best of your knowledge.

Submit applications by the deadline of 5pm August 18, 2017 to the Community Foundation for Nantucket. We prefer that applications come to us by email, if mailing, they must be postmarked by August 15, 2017.

Keep a copy of your submission for your files

Please do not include videos, promotional materials or any additional information other than what is requested on this form. An interview will be conducted by a representative of Healthy Nantucket 2020 and at that time the video or other materials can be presented.

Submit one (1) copy of the following in this order:

  • Completed 2017 Grant Application PDF or WORD
  • Names and addresses of the current Board of Trustees if available or appropriate
  • Copy of the letter from the IRS stating your tax status i.e. 501c3 or other.
  • Copy of your most recent Form 990 (if applicable) and complete financial statements in accordance with Commonwealth of Massachusetts requirements.
  • If applying with a fiscal sponsor, please include a copy of a letter signed by the head of the organization acting as fiscal sponsor accepting responsibility for any funds received. Also include a copy of the minutes from the fiscal sponsor’s Board meeting where the relationship was approved.
  • Applications from for-profit businesses or organizations that meet all the eligibility criteria will be considered, but most also be pre-authorized by the Department of Public Health to receive funding. Working with the applicant, NCH and CFN would request authorization from the DPH.

If at any time you have difficulty with this application, please contact Jeanne Miller at 508-823-9993 at the Community Foundation for Nantucket.

Meet your Nantucket Cottage Hospital clinicians
across more than 30 different subspecialties: