Foundation Funding Application Process

Quincy Medical Group Foundation will award funds, scholarships, and donations two times out of the year. We will host a Spring and Fall check presentation with the awardees. Please see the timeline below. All applicants must complete the Foundation Application for funding. Click here to download the funds application or fill out the form below.

Date	Description
January 1 – April 1	Open submission for Spring applications
June 1	Funding notifications for Spring awards
June 1 – October 1	Open submission for Fall applications
December 1	Funding notifications for Fall awards

All funds must be received at the Quincy Medical Group Foundation by 5:00 pm on April 1st for consideration for the Spring funding cycle.

All funds must be received at the Quincy Medical Group Foundation by 5:00 pm on October 1st for consideration for the Fall funding cycle.

Is your organization a government unit or a public charity that is non-profit and tax-exempt under 501 (c)(3) of the IRS Code?*
If applicable, please attach a copy of your IRS exempt determination letter.
Accepted file types: jpg, gif, pdf, doc, docx.
Have you ever received funding from the QMG Healthcare Foundation?*
If you answered yes to the above question, for what program or project?
Name of your Organization/Program*
Address of Your Organization*
Street Address Address Line 2 City State ZIP Code
Name of Individual Completing Application*
First Last
Phone
Email
Brief overview of your mission and organization/program*
Which one of the Foundation focus areas are you applying for funding for?*
- Youth Partnerships & Programs
- Health
- Community Development
Dollar amount of funds being requested*
Intended use of funds*
Please attach any copies of bids, invoices, price quotes, or project financial statements or budgets to show how funds will be utilized
Accepted file types: jpg, gif, pdf, doc, docx.
What is the proposed time frame for using this funding?*
How many people will benefit from the project and what age group is being targeted?*
What geographic location will this project or program impact?*
Is this a pilot program? If not, please explain how it was previously funded*
How do you plan to maintain this project/program following initial QMG Healthcare Foundation Funding?*
How would only partial funding from the Foundation impact your ability to provide this project, program or meet general support needs?*
How will your organization contribute to this project?*
Is there the possibility of alternative funding for this specific request? If so, from what sources and in what amounts?*
Do you agree to file a QMG Healthcare Foundation funding report setting forth the expenditure of the funding money, when it was expended, to who it was paid, and the benefits received from the funds?*
Signed*
Today's Date*
Date Format: MM slash DD slash YYYY

(Age 6 months and older)

(Age 6 months and older)

Foundation Funding Application Process