Circle of Compassion Grant Application

Application for Circle of Compassion Grant

Please complete the following form to apply for a grant from the Circle of Compassion program. Required fields are marked with an asterisk (*).

Contact Information

Name of your center: *

First Name of person in charge: *

Last Name of person in charge: *

Their Title/Position: *

Email Address *

Phone *

First Name of person filling out the form, if different than the person in charge:

Last Name of person filling out the form, if different than the person in charge:

Your Title/Position::

Email Address

Phone

Center Information

Center Address *

City *

State/Province *

ZIP / Postal Code *

Website

Do you have a Facebook page or group?

Yes

What is your Facebook Page or Group?Please enter any your FaceBook Page or Group here.

Do you have an Instagram page?

Yes

What is your Instagram link?Please enter your Instagram link here.

Do you have a YouTube channel?

Yes

What is your YouTube Channel?Please enter any your YouTube channel here.

Do you have a Twitter account?

Yes

What is your Twitter handle?Please enter your Twitter handle here.

Do you have any other social media accounts?

Yes

What other social media accounts do you have?Please enter any other social media accounts here.

Can we promote your center on social media?

Yes

Your logo

No file chosen

If you have a logo we can use to promote you on social media please upload it here

Are you a 501(c)(3)? *YesNo

Submit proof of your food policy/plan adoption: *Policy/plan on letterhead signed by the executive director or board (attachment?)Policy statement on your website (Link)Other (attachment?)

Your food menu/policy/plan:

No file chosen

Policy statement link

What date did your center adopt this menu/policy/plan? *

What was your previous food Menu/Policy Plan? *Please describe your previous food Menu/Policy Plan here.

Can we share your policy (we will credit your center)? *YesNo

Which grant are you applying for? *

Anything else that you would like us to know: