The mission of the Bethesda Foundation is to support health related activities within the geographic area served by the original Bethesda Hospital.

Summary of Application for Funding

Date :
Organization Name :
Contact Person for Grant :
E-mail of Contact Person :
Organization Directors Name :
Street Address :
City :
State :
Zip Code :
Contact Telephone Number :
Years in Operation :
Please Describe the Purpose of Your Organization
About Your Request
Purpose for Which Funds Requested :
Capital Operating Special Project Seed Money
Total Operating Budget for Current Year :
Total Cost for Project :
Are Their Public Dollars That Could Be Used to Fund This Project? :
Yes No
What Similar Projects are Being Done in this Area?
Please Provide a Brief Statement of Need (What will this grant, if awarded, enable your organization to accomplish?
Do You Have an Operating Deficit? :
Yes No
If Yes, Why?    
Amount Being Requested :
Please Explain How the Success of this Project Will be Measured
By When? :
By Whom? :



Grants are made by approval of the Board of Directors, which meets quarterly to consider the recommendations of the Grant Committee.

A Grant may be awarded as matching funds. The Board may also award a grant on a challenge basis, if it appears that such an award would assist an organization in raising other funds.



Grants are limited to qualified non-profit organizations located in, or directly serving health-related needs of the residents of the former Bethesda hospital operating area.

The Foundation does not make grants to individuals, or organizations for religious or political purposes. It generally does not contribute to endowment funds, or to help offset operating deficits. It does not generally give to annual operating campaigns of local chapters of national organizations.



The Bethesda Foundation focuses on and is limited to health related service in the greater Hornell, New York area. The Foundation will consider proposals for unrestricted operating support, but generally awards such grants on a one-time basis.

The Foundation will consider proposals for capital needs or for special projects. The Foundation is particularly interested in assisting programs meeting an urgent community health related need, not necessarily duplicating the work of other programs, and which have explored alternative funding sources.


The Foundation will provide assistance to qualified organizations in the preparation of grant proposals. Proposals should include the following information about the applying organization, the project, and the finances for the project.


  • Copy of certificate from The Internal Revenue Service recognizing charitable tax exempt status

  • Copy of most recent audited financial statements

  • Copy of budget for current fiscal year

  • Current list of Boards of Directors and/or Advisory Board, showing affiliations of members

  • Copy of most recent annual report



  • Brief narrative explaining need met by project, plans for carrying it out, and how success will be measured.

  • Job description and qualifications for personnel responsible for project



  • Copy of budget for project, showing breakdown of expenses, as well as both earned and contributed income

  • List of all sources from whom funds have been or will be sought for this project, and their responses to date


NOTE: If applying for operating and project support, an organization should be able to demonstrate the probability of future ongoing funding from other sources to replace whatever funding the Foundation might provide in the current year.



• Summary sheet (form available from Foundation office)

• Accountability information will be required

• Additional information as requested