Healthy Blue Moving Forward Grant Nomination Form
**CONFIDENTIAL** PLEASE NOTE THAT ALL IDENTIFYING INFORMATION SHARED IN THE NOMINATION FORM WILL REMAIN CONFIDENTIAL AND WILL NOT BE USED FOR ANY PURPOSE OTHER THAN GRANT RECIEPIENT SELECTION BY THE FOSTER PANTRY MOVING FORWARD COMMITTEE ~ WHEN ANNOUNCING THE AWARDS IDENTIFYING INFORMAITON (SUCH AS NAMES) WILL NOT BE USED WITH OUT THE YOUTH'S PERMISSION IF 18 YEARS OR OLDER. NO IDENTIFYING INFORMAITON WILL BE USED FOR YOUTH UNDER 18*****

Healthy Blue of North Carolina has sponsored $5000 in Grants for our Moving Forward Program.

With these added funds we will be accepting nominations for our local youth to receive a $500 Healthy Blue Moving Forward grant.  Nominations can come from the youth's social worker, LINKS coordinator, or Guardian ad Litem.

ELIGIBILITY​:
>Youth who have or have had foster care cases in (New Hanover, Brunswick, Pender, Onslow, Duplin, Bladen & Columbus counties
>Applicants must be currently in foster care OR aged out of foster care OR obtained guardianship from foster care after 16 years of age.
>A high school senior (graduating 2022) and/or between the ages of 18 & 21 at the time they apply.

Funds can be used towards expenses associated with, continuing education, developing a new skill or trade, obtaining a new job/career/promotion, or military enlistment.

Nominations are due by June 6th 2022 by 9pm.
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Email *
Name of Nominator: *
Phone Number (Nominator) *
Nominators Relationship to Nominee *
Required
Nominator's Agency Affiliation *
Required
Nominee's Name: *
Nominee's Phone/Email: *
Agency of Nominee's Foster Care Case *
Required
Nominee's Current County of Residence *
Nominee's Age *
What are the youth's higher education, career and/or future goals and how will the Moving Forward Scholarship help achieve those goals? *
Please tell us about the nominee and why you feel the youth should receive a $500 grant?
A copy of your responses will be emailed to the address you provided.
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