Grant Application Form

Before you begin

Tips for Navigating the Application Form

You may preview the full application by navigating through each of the five pages at the top right corner of this form or view a copy of the full form. Only proposals submitted through this online form will be accepted.
To progress to the next page, please use the "Next Page" button or navigate across pages using the numbered tabs at the top of the page.
To prevent losing your work, do not use the "Back" or "Forward" buttons on your browser.
To ensure that your progress is saved, we recommend using the "Save my progress and resume later" option located at the top and bottom of this page. After entering your email address and creating a password, you will receive an email containing a link to this form. This link will allow you to return to your application at any time during the open application window.

Tips for Completing the Application

Add no-reply@formassembly.com to your safe senders list to ensure you receive all system communications.
Limit your use of bullets and other formatting.
Certain responses on this application use word limits. Questions with word limits will display a live word counter below the question field. You are welcome to submit a response of any length up to the word limit.
You may find it useful to use a word processing tool with a word count feature (such as Microsoft Word) to draft your responses, then cut and paste your answers into the application form.
To submit your application, please first click the "Submit" button on the last page. You will then be prompted to review your responses to the application in its entirety. After reviewing, select "Confirm" to complete the submission.

Have Questions?

If you have questions about your eligibility or the grantmaking process, please see our  Request for Proposals.
For  technical questions  specific to this application form, please contact us and include “Technical Application Question” in your subject line.
Applications are due 11:59pm UTC on December 9th, 2024. All applications will be evaluated after this date. Questions about the request for proposals (RFP) and application process may be submitted to T1DCommunityFund@panoramaglobal.org.

Part II: Funding Request

*required

Describe the type 1 diabetes services your organization provides and why they are important to the communities served?

300 word maximum

Describe the clients and/or patients that your organization serves.

300 word maximum

Please share any measures of impact you use that are relevant to your work.

300 word maximum

How would your organization use support from The T1D Community Fund to sustain and/or scale your impact on type 1 diabetes patients? What impact would you plan to achieve with the funds? Please be as specific as possible.

600 word maximum

Is this funding request to support existing type 1 diabetes programming or a new initiative at your organization?

Existing type 1 diabetes programmingNew initiative at your organization

Please indicate the total cost of the new initiative, including funds requested from The T1D Community Fund and other committed sources of support.
In USD$

Please indicate the total amount requested from The T1D Community Fund.
In USD$

Part III: Attachments

*required

English language documents are preferred, if available. Please note that additional documentation may be required depending on the country from which you are applying.

Confirmation of charitable status (e.g. NGO registration certificate, articles of incorporation, bylaws and/or governing documents)

Current FY budget, including both revenue and expenses

YTD financial statements, including income statement and balance sheet, at minimum

Prior fiscal year financials, audited preferred

Key leadership / staff bios

Project proposal / budget: (if applicable)

I certify that the information provided in this application is true and correct to the best of my knowledge. I further understand that any false statements may result in denial of this request for funding.

I agree