Apply Now Fill the Form Below to Apply Now. After filling this form, we will get working on your application immediately and we will keep you updated via the email you enter below. Application Name * Name First First Last Last Address Address Address Address City City State/Province State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Gender * Gender * Male Female Date * Phone * Citizenship Status * Citizenship Status * U.S. Citizen Resident Alien Green Card Holder Permanent Resident Others Relationship Status * Relationship Status * Single Married Hearing * Hearing * Hearing Deaf Hearing with Aid Occupation * Annual Income before taxes * Living Condition * I own a House Rented Apartment Preferred Withdrawal method * Preferred Withdrawal method * Cash Check Bank Transfer Have you applied to any other charities / Organizations for assistance for raised any funds through fundraising events? * Yes No Occupation Category (BUSINESS FUNDING) Statup Capital, Expand Business, Home Based Business, Inventions (REAL ESTATE: INVESTING/BUSINESS) New Construction, Rental Properties, Commercial (COMMUNITY FUNDING) Performing Arts, Humanities, Crime Prevention, Disaster Relief / Prevention (EDUCATION/ TUITION FUNDING) Tuition, Student Financial Aid, Stafford Loans, Scholarships, Research REAL ESTATE: PERSONAL HOME PURCHASE/ 1ST TIME HOME BUYER (PERSONAL ASSISTANCE) Medical Expenses, Food Stamps, Child Care, Rent Assistance, Veterans (PERSONAL ASSISTANCE) PERSONAL ASSISTANCE: HOME REPAIRS How would you describe your credit? * Excellent Good Fair Poor What Email address would you like to use for your Username for your NIH Grant Application Account? * Describe what you will use the money for? * What unique things would separate you from other applicants applying for this money? * The NIH foundation, its employees, will keep your personal details secure. The information given on this form will only be used to consider your application for the Grant offer . Your information will not be shared with any other third party without your consent. The confidentiality of your personal information is of paramount concern to us. We are registered with the Information Commissioner’s Office as a data controller under the Data Protection Act 1998 and will process and hold your personal information in accordance with legislation. If you are human, leave this field blank. Submit