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About DAISY Medical Mission Grants

Details:

Grant Amount

Grants of up to $1,500 each will be funded for upcoming mission trips. Funding is not available for mission trips already completed.

Who is Eligible?

Applicants must be DAISY Award Honorees who have been registered with The DAISY Foundation. If you don’t know if you have been registered with us, please visit www.DAISYFoundation.org. Type your name into the search bar at the top of the home page. You should find your DAISY Spotlight page. You’ll need the URL for this page for the application. If your page does not appear, please ask your organization’s DAISY Coordinator to register you before you complete your application. Please note, you may not apply for and receive this grant more than three times.

About You

First Name

Last Name

Credentials

Title

Email For All Mission Correspondence

Your Phone Number

Your DAISY Honoree Information

Please note: In order to be eligible for DAISY Medical Mission Grant funds, you must be a DAISY Honoree and be registered on our website: www.DAISYFoundation.org. If you have any questions about your status as a DAISY Honoree, please contact FaithThomas@daisyfoundation.org for assistance. Thank you!

Date DAISY Award received (MM/YY)

Link to your DAISY Spotlight from DAISYFoundation.org (You'll find this by going to www.DAISYfoundation.org and typing your name into the search box. Go to your Spotlight page, and copy the URL for that page. Then paste it in this field.) :

Current Employer Information

Current Facility Name:

Current Facility Address:

Street Address

City

State

Zip / Postal Code

Country

Mission Details

Who is the organization coordinating the mission?

Is this the coordinating organizations first mission?

Please provide the website for your coordinating organization:

Coordinating organization's purpose for this mission? (You may need to ask the coordinating organization for this information.). 100 words max

How many people do you expect this mission trip will serve? (You may need to ask the coordinating organization for this information.)

Date mission trip starts:

Date mission trip ends:

Number of days you will participate in the actual mission (not including travel days)

How did you hear about the DAISY Medical Mission Grants Program?

Mission Location Information

Country where mission will take place

Village/Town/City where mission will take place (40 characters max)

Proposed Budget

Only your direct costs are reimbursable. Salary and vacation time are not reimbursable.
Alcoholic beverages are not reimbursable.

What The DAISY Medical Mission Grant Will Cover:

Meals

Air/Rail

Hotel

Car Rental

On-line transactions

Clinical Supplies

Please download this spreadsheet, fill in your proposed expenses, and upload the completed document below.

Proposed Budget

When you return from your trip, you must provide adequate documentation supporting the expenses and their purpose to be reimbursed, and clearly highlight those items on the receipt.

Mission Resources

How much are you hoping DAISY will fund (up to $1,500.00 per grant)? (Please us format X,XXX.XX)

What is the total cost of the mission to you? (Please us format X,XXX.XX)

Does your employer give you time off for missions, or are you using vacation time? (hold Ctrl key for multiple selection)

If you need additional funds, how will you raise them?

Your Mission Experience

Provide your name as it should appear on the check and the address for funds to be to, should you be selected:

Full Name:

Street Address

City

State

Zip / Postal Code

Country

Your service on this mission

As a nurse, what specifically will your role be on this mission, and how do your nursing skills align with the needs of this mission and the area where you are serving? Successful applicants speak to the medical services they provide. (Max 250 words)

Do you need a temporary license to practice in this country?

Will the mission organization be providing the license?

How do you plan to acquire the license? (Max 25 Words)

As a DAISY Nurse, what do you expect your contributions to the outcomes of the mission will be? (Max 250 words)

Why is participating in this mission important to you personally? (Max 250 words)

Your impact is not only what you do on your mission, but what you share about your mission with others. Please tell us how you will disseminate the experience you’ve had with others in healthcare and beyond. (Max 250 words)

Waiver

We require all applicants to sign and submit a liability waiver so that it is automatically on file should your application be selected to receive funds. Please download, sign, scan and attach to this document as the final step for submission. Download waiver here.

Upload Completed Waiver

Thank you for your application. Should you have any questions, please contact FaithThomas@daisyfoundation.org

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