Greater Bedford Womenade

Only GBW's validators may complete the funding request application

Individuals seeking support should click here.

Validator Funding Request Form

1. Complete the information below in the grey boxes.

2. Scan or email a copy of the vendor's invoice for service or item requested. This will enable timely distribution of funds for approved applications.

3. Complete the release form which you can access by clicking here and then return it to GBW by scan, email, or U.S. mail after submitting the application.

Validator's Name
Validator's Agency
Validator's Email Address
Validator Preferred Phone
Zip code where the person in need lives.
Please describe what event or circumstance occurred that caused a crisis, a sudden upheaval, in your client's life. Be as specific as possible.
How is your client prepared to address the financial needs of the next few months ahead?
If your client is unemployed, please indicate what the client is doing to secure work.
Please list service agencies or providers that have been contacted for support and describe help offered. Please be as detailed as possible.
What is the total amount of funds needed? If the total is more than $500, please indicate specifically where the remaining funds are coming from.
Name and address for vendor payment..
Client Account # with vendor or other identifying information so payment is credited properly.
Vendor Phone Number
Have you received funding for this client from GBW within the last 12 months?
- Yes
- No
Has the person in need signed GBW's Release?
- Yes
- No
Have you prepared to email the vendor invoice to GBW?
- Yes
- No
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Thank you for contacting us. We will get back to you as soon as possible

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If you would like to be considered as a validator for GBW and you work within a social service organization serving people living in Bedford, Goffstown SAU, or Manchester, please click here.

NOTES TO VALIDATORS AS YOU FILL OUT THE FORM:

So that GBW may support as many people as possible, we fulfill each individual's needs once per year.

Unfortunately, we are not a long-term solution for people in need.

All requests must keep recipient names anonymous.

Funding is distributed directly to the vendor, and there is a $500 limit on each request. For requests where funds cannot be paid to a vendor, the validator or its organization must purchase the approved items and submit the receipt to GBW for reimbursement.

GBW trusts that the validator will endorse one request per individual or family per year.

We consider requests for funding that fit within our mission statement and definition of crisis, posted at right.

GBW is no longer funding car repairs.

Our Mission Statement:

GBW strives to provide immediate, short-term financial assistance to members of the local community in crisis,* recognizing other means of support may not be readily available. Further, we strive to periodically support existing or new programs that benefit at-risk populations in our service area that aim to avert crisis.

Our Definition of Crisis:

A sudden change that creates financial, social or emotional upheaval that needs urgent action to enable relief.

Greater Bedford Womenade

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