Internal Grant Application Form

Application Information

Mary Free Bed Guild Fund Mission:

The Mary Free Bed Guild Fund supports the charitable, scientific, and educational purposes and missions of the Mary Free Bed Guild and its subsidiaries. The Mary Free Bed Guild Fund also supports community organizations and activities whose focus is on the education, recreation, health, and well-being of the disabled population in western Michigan.

Mary Free Bed Guild Mission:

Restoring hope and freedom by continuing the traditions of benevolence and compassion through governance of the hospital and support of community and hospital programs.

Purpose:

To provide funding for projects of the Mary Free Bed Rehabilitation Hospital, and the Mary Free Bed Guild. Special consideration will be given to projects that will be self-perpetuating.

Amount and Duration of Grants:

Grants between $1500 – $20,000 will be considered. A limited number of projects/programs may be considered for larger grants. Renewal requests will be considered.

Application:

• The applicant must be a Mary Free Bed employee, a Medical Staff member, or a Guild member.
• Projects/programs must be approved by a department or clinical program.
• The department or clinical program, including the department manager and vice president, must approve the project/program and all participants.
• Hospital operations should not be adversely impacted by the project/program.

Grant Request Guidelines:

The proposed project/program:

• Will demonstrate a clinical significance in patient care.
• Is designed to be self-perpetuating.
• May have support of multiple departments or clinics within the hospital.
• If a formal research project, must be approved by the Hospital Research Institutional Review Board.
• May be considered when other funding within the hospital is not available.
• Grant proposals which include funding from other sources are strongly encouraged.
• Routine department or project/program operating expenses will not be considered.

Processing of Requests:

Requests will be reviewed by MFB Management, then forwarded to the MFB Fund Board for action. The Fund Board will review and discuss each request. Additional information may be requested, which should then be provided at least one week prior to the Fund Board meeting. The Fund Board meets the third Tuesday of September, November, January, March, and May. Requests and ALL required documentation must be received by the first business day of the meeting month.
Requests received after the first business day of the meeting month will be considered at the next scheduled meeting. Notice of the status of your grant request will be received within thirty (30) days of the Fund Board meeting.

Reporting of Approved Grant Results:

Annual budget review and progress report are required within six months of project/program funding approval. These should be sent to the Guild Administrator who will send them to the Mary Free Bed Fund President and Board.

Required documents (for all new and renewal applications):

Applications missing any of the below required documentation will be returned.

1. Current and past year project/program budget or organizational operational budget.
   • Please provide separate columns for current and past year budgets.
   • Please explain any line items that show significant change between the two years.
2. An accounting of the most recent year’s activities including:
   • Balance sheet and income statement
   • Donor breakdown (include all major donors and amounts donated last year)
   • Expense breakdown
3. Any Additional information about your programs or financial situation that would help clarify items in the request.
4. Tax exempt letter or evidence of your tax-exempt status
5. W-9 Documentation