Hospital Foundation Grant Application

The Hospital Foundation, with the help of volunteers, internal departments, special events, and personal contacts raises funds to benefit DCMH and its programs. Those funds are distributed in three rounds throughout the funding year. Applications for funding are due by the 10th of the month in February, June and October with a maximum funding amount of $5000 (with exceptions made based on merit) and a single award per department per year.

This form must be submitted no later than 12 noon on the 10th of the month in which the application will be reviewed - February, June and October. The application must also be made no less than one month in advance of the event or need.

Funding Request Submission Information
Request Date:*
Annual Event:*
Previous Grant's Final Report Submitted:*
Event or Equipment Information
Request Type:*
Event Title or Equipment Name:*
Expected Outcomes
Financial Information
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By submitting this form you are verifying the accuracy of the information. Also, in the event your project is funded you are agreeing to submit a final report within 30 days of the project completion.