Request for Financial Aid | Medicine Wheel Ride

Medicine Wheel Ride Financial Assistance Criteria

Before applying for financial assistance, please see this link for application criteria and common questions and answers about how the awarding of funds.

MWR is not law enforcement and we do not replace official investigations.
MWR does not promise outcomes; we commit to support, advocacy, visibility, and community response.
MWR is not and emergency service provider nor doe we provide crisis intervention.
MWR does not take on work that is outside our mission scope.

Form for Financial Assistance

First name

Last name

Organization name

Address

Phone

Have you applied for funding with Medicine Wheel Ride in the past?

Yes

If yes, please provide date(s) and assistance amount(s):

Is this request for an urgent or immediate situation?

Yes

Please explain:

How did you hear about us? (Friends, Social Media, Other)

Please let us know your friends name or Other if selected how you heard of us?:

Are you Indigenous or is the organization Indigenous led?:

Yes

If you are connected to a specific Tribe or culture, please specify:

For Organizations

What issues does your work focus on for our Indigenous communities? Please provide a recent example of a project, event, or grant you provided.:

We agree to provide Medicine Wheel Ride with information about how the financial assistance was used and the demographics of the recipients

Yes

If no, please explain:

Are you a 501 or 501(c)3 non-profit?:

Yes

Do you receive major funding?:

Yes

Other

For Individuals

If applicable, name of Missing/Murdered loved one you are applying for:

Would you like Medicine Wheel Ride to feature a story about your loved one?:

Yes

For Individuals and Organizatiosn

What types of things will the money be used for? How will financial support help you achieve the objectives of your mission? Please give as much detail as possible (how many will be helped, where, etc.):

Choose a grant amount you are requesting. Be aware that anything over $600 must be reported to the IRS and you will receive a 1099 form from us.:

Please Note: Funds will be distributed via Check, PayPal, or Zelle.

Please be aware that if you are requesting funds for merchandize or purchased goods or services, you will be required to submit estimates and quotes from the most cost

effective vendors.

Medicine Wheel Ride will respond to all Request for Financial Assistance within 10 business days.

If this request is for an event, we require 30 days’ notice prior to the event.

Mandatory for Organizations, Optional for Individuals

If funded, do you agree to mention MWR or use our logo advertising or marketing?:

Yes

If funded, do you agree to complete our project progress report for inclusion in our annual report?:

Yes

Anything else you would like to add:

When do you need the funds distributed by? Please allow ample time for the board to review grant request.:

Date

Month

Day

Year

Signature

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