Apply for a Gift | Friends of Meriter

If you are involved with a non-profit organization that improves the health and well-being of our community, Friends of Meriter encourages you to apply for a Friends 4 Friends gift. Please fill out the questions on this page. Note that Friends of Meriter has the right to approve or disapprove all funding requests.

If you would like to send any supporting materials, please send them to: Volunteer Services/Friends of Meriter, UnityPoint Health - Meriter, 202 S. Park Street, Madison, WI 53715. Please note which gift request they relate to.

Submission Form

* = Required Fields

About You

Name * Address * City * State * Zip * Email *

About the Organization

Organization to Receive Gift Address City State Zip Contact Person of Non-Profit Organization Contact Person's Phone Number

IRS Non-Profit Organization Yes No

IRS Tax Number

Relationship to Meriter

Relationship to Meriter (Note that you must have a relationship to Meriter to request a gift) Employee Volunteer Physician

Meriter Department

About Your Request

Write a brief statement describing the goals and objectives of this project. Explain your volunteer involvement with the organization. How much are you requesting and is there a deadline for your request? How will the funds be used? Be specific. How will the donation from Friends 4 Friends be recognized? Who and how many persons will be served by the program/project? List other funding sources for the program/project.

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