New York Life Foundation Grant Application

GSSI School Pledge Form

* indicates required field

Pledge to be Grief-Sensitive by either:

Requesting a presentation from a New York Life GSSI Ambassador who can provide information about the Coalition to Support Grieving Students. By participating in New York Life’s Grief-Sensitive Schools Initiative, we hope that your school community will strive to be grief-sensitive. Each school that received this presentation and strives to be grief-sensitive, will receive a $500 grant to support its efforts.

Agreeing to strive to be grief-sensitive based on the criteria below if your school has already received training on childhood grief from another source.

Strive to Be a Grief-Sensitive School by:

Sharing information with your school community about the Coalition to Support Grieving Students’ materials at GrievingStudents.org

Increasing the awareness of the issue of grief at school

Reviewing relevant school policies and procedures to ensure that they are grief-sensitive

Providing specific professional learning opportunities about childhood grief to your school staff

*Pledge to be a Grief-Sensitive School by requesting a presentation:	My school would like to request a presentation from a New York Life GSSI Ambassador who can provide information about the Coalition to Support Grieving Students. By participating in New York Life’s Grief-Sensitive Schools Initiative, we hope that your school community will strive to be grief-sensitive. Each school that received this presentation and strives to be grief-sensitive, will receive a $500 grant to support its efforts.
Pledge to be a Grief-Sensitive School because my school received training on childhood bereavement.	If your school has already received training on childhood grief from another source., your school can pledge to be grief-sensitive if they agree to strive to be grief-sensitive based on the criteria above. I agree to be listed as a Grief-Sensitive School
*First Name
*Last Name
*Position/Title:
*District Name
*NCES District ID	NCES District ID
*School Name
*NCES School ID	NCES School ID
*School Level
Address	Address
*City	City
*State	State
*Zip	Zip
*E-mail Address
Telephone
Is there interest in all schools in the district to receive a GSSI presentation?	Please note: Presentations can be done individually or in large groups. Each school that participates in a GSSI presentation (a minimum of five school personnel from each school must be present) and agrees to strive to become grief-sensitive will receive the $500 grant.
Primary reason for requesting this presentation
If other, please explain:
How did you hear about this initiative?
NYL Nonprofit Partner
Please specify:	(500 character maximum)
Other Questions/Comments:	(4000 character maximum)