Grant application Form

To expand HeartGift's mission and increase access to care for children in Asia, Africa, and Latin America affected by congenital heart defects, we will collaborate with local experts to establish or enhance pediatric cardiac programs. By connecting healthcare professionals, volunteers, and resources, we aim to create sustainable solutions that provide life-saving care to families in need.

Step 1 of 5

ORGANIZATION PROFILE
Name of qualified organization*
Contact person*
Title*
Email*
Phone
Organization website:
Annual operating budget
Federal incorporation number
Year of incorporation
Mailing address
Number of employees (full/part-time)
Number of volunteers
Board Chair & Term
Number of board members
Audited Financial Date: (if yes, please attach)
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File
Max. file size: 50 MB.
990 Tax Filing Date: (please attach)
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Max. file size: 50 MB.

Grant application Form

Step 1 of 5

ORGANIZATION PROFILE

REQUEST:

PROGRAM DETAILS

GOALS & OVERSIGHT:

PROGRAM IMPACT:

USE OF FUNDS: