ATTENTION: THIS IS NOT THE "IN THIS TOGETHER FUND" APPLICATION FOR COVID-19 FINANCIAL RELIEF. IF YOU WOULD LIKE TO APPLY FOR "IN THIS TOGETHER" FUNDING, PLEASE CLICK HERE.

An application to request funding may be completed by any requesting organization, program, or individual. An application may also be completed on behalf of an organization, program, or individual by a supporter of that cause. Grant recipients are not required to be 501(c)3 charitable organizations.

Applications must be completed in full and signed by the requesting party.

The HCAR Cares Board of Directors will review applications during its monthly regular meetings. Applications must be submitted to HCAR staff at least five (5) business days prior to a board meeting for it to be listed on the agenda. The board meets on the second Thursday of every month.

Applications will be rated by the HCAR Cares Board of Directors based on the following: Completeness and quality of application; The request’s alignment with the HCAR Cares Mission Statement and Vision Statement; Use of funds.

Assistance is not limited. Discretion to make funding commensurate with need is given to the HCAR Cares Board of Directors, depending on availability of funds.

Successful applicants may receive funding as a check, credit card payment, or gift card donation. HCAR Cares must be provided with a confirmation of donation in writing via a formal letter or email.

Successful applicants will be invited to a voluntary check presentation, where a photo will be taken.

Please note that you are unable to save your progress on this application, so please review all of the questions, gather your responses separately, then complete and submit this application. If you have any questions, please contact Sarah Rayne at hcarcaresmd@gmail.com or at 410-980-0443.

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* 1. Date

Date

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* 2. Your Name

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* 3. Your Phone Number

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* 4. Your Email Address

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* 5. Name of organization, program, or individual to receive funding

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* 6. Your relationship to the funding recipient

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* 7. Name and contact information for the organization, program, or individual, if different from above. If not applicable, skip to the next question.

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* 8. If you are applying on behalf of an organization, program, or individual, are they aware you are making this application?

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* 9. Please provide background information on the organization, program, or individual.

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* 10. Amount Requested (Please note that you  may be approved for an amount other than the one you request here, at the discretion of the HCAR Cares Board of Directors.)

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* 11. Purpose of Grant (Be as specific as possible)

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* 12. Supporting Documents 1

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 13. Supporting Documents 2

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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* 14. Supporting Documents 3

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
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* 15. By signing below, I acknowledge all the information provided in this application is accurate to the best of my knowledge and I release this information for consideration by the HCAR Cares Board of Directors.

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