$500 Grants Available to Support FACE Poverty Initiatives We Are Looking for Projects That: Address healthcare disparities facing children who live in poverty Integrate a QI framework for evaluation and improvement Show commitment to collaboration with community partners Demonstrate a plan for sustainability Eligibility Requirements: AAP SOMSRFT member in good standing Medical student or postgraduate status as of July 31, 2015 Logistics: One grant will be awarded following the 2015 AAP National Conference and Exhibition to a project in the district with the most submissions to the FACE Poverty Interactive Map Four additional grants will be awarded during the 2015-2016 campaign. Submission deadlines are: o November 30, 2015 (notification by December 15, 2015) o January 31, 2016 (notification by February 15, 2015) o March 31, 2016 (notification by April 15, 2015) o May 31, 2016 (notification by June 15, 2015) For more information about the FACE Poverty Campaign, please visit our website. Submission Instructions: Please email the following to KVandenbrook@aap.org: Letter of support from your institution (faculty advisor is fine) Completed submission form 2015-2016 FACE Campaign Tri-Chairs Alexandra James, MD Gaby Polyak, MD Genevieve Guyol FACE Poverty Grant Application Contact information (of primary applicant) – First and last name: _________________________________________________________________________________ Medical school or residency institution: ___________________________________________________________ Program year (eg. MS3, PGY1): _____________________________________________________________________ Contact email address: ______________________________________________________________________________ Contact phone number: _____________________________________________________________________________ Co-applicant contact information – Full name Program year 1. 2. 3. Email address Biographical Information – For primary applicant and co-applicant, please provide a BRIEF description of relevant experiences and/or skills that prepare you to execute this project. Short answers (please note word limits) – 1. Describe your project and how you know that this approach is a key lever in addressing the healthcare needs of children living in poverty. (1000 words) 2. How does your project build on the work of others and/or existing scholarship? (500 words) 3. How will you ensure that your project is sustainable? (500 words) 4. How will you collaborate with community partners? (250 words) 5. How will you integrate the QI framework into your project? (250 words) Provide an itemized budget of how you plan to spend the $500. Application Certification: I __________________________ (project leader) hereby certify that all the questions on the application form have been answered completely and accurately to the best of my knowledge. If I receive the award, the $500 check will be used for the project named above and the check should be made out to: ______________________________________. Checks can be made out to individuals or institutions. Please note that you will receive a tax statement from the AAP if you receive $600 or more from the AAP in the calendar year.