EmailMe Form - Foundation Mini-Grant Application

Eligibility Requirements

• Currently employed (full-time or part-time), work for a facility, housing, home care, or community member of Care Providers of Minnesota

• Eligible expenses can include course fees/book fees/seminar fees and/or testing fees that contribute to professional development and may lead to career advancement in long-term care.
Mini-grants can not be used for past education or continuing education to maintain one's license.

Applicants are only eligible to apply for one mini-grant per year

CPM Foundation Mini-Grants will be available beginning on April 1, 2024 with an open grant period to end on December 31, 2024.

Applications will be accepted on a first come, first served basis and funds will be granted to eligible applicants until such time that the designated fund is depleted. Maximum amount to be given is $500.00 per applicant.

I have read and understand all the eligibility requirements. *

YES

NO

Name *

First Last

Email *

Home Address *

City *

State *

Zip Code *

Personal Phone *

### - ### - ####

Employer's General Phone Number *

### - ### - ####

Current Employer *

Current Employer Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Purpose of the grant (describe the expense to be incurred) *

How will this education/successful test completion advance your long-term care career? *

Have you applied for a Care Providers of MN Foundation Scholarship or Mini-grant before? *

Yes

No

If yes, when?

Attestation - With this signature I attest that the expenses noted above is accurate and eligible for a Care Providers of Minnesota mini-grant; I have attached information on proposed education/test

Signature of Applicant *

Date: *

Supervisor: With this signature I attest my support for the applicant to receive this grant for the purposes noted above.

Signature and Title of Supervisor: *

Date *

File Upload *

Please make sure to upload required documentation when submitting your application.