Grant Application

Buckle Up for Life

2018-2019 Grant Application


Before filling out the application, please read the following program overview and requirements.

Application Deadline:
March 22, 2018 at 8:00 pm EST

Please note: You will know that your application has been submitted when you receive a confirmation message after hitting the submit button.


Vision Statement

To be the leader in eliminating motor-vehicle-related injuries and deaths among children.

Mission Statement

Buckle Up for Life will provide child-passenger-safety education and life-saving resources to families everywhere.


Motor vehicle crashes are one of the leading causes of death among children.

The Buckle up for Life/Abróchate a la Vida program was designed by Toyota and Cincinnati Children’s Hospital Medical Center to decrease the number of auto-related injuries and fatalities by instructing families about the proper use of safety belts and child restraints.

Program History

Buckle Up for Life was modeled after successful faith-based, motor-vehicle-safety interventions in African-American and Hispanic communities in Cincinnati, OH. Relying on trusted faith leaders to raise enthusiasm and support among congregants, the initial program introduced messages about child-passenger safety and motor-vehicle safety in churches. While Buckle Up for Life continues to have a strong presence in the faith-based community, the program has since evolved and expanded to also partner with schools, emergency service agencies, and community-based nonprofits serving any at risk population. To date, the program has been implemented in 34 cities across the country. We have observed consistent increases in restraint use among both adults and children who participate in the program.

Program Setting

Buckle Up for Life partners with churches, and nonprofit and public service agencies to serve at risk populations with low rates of seat-belt and car seat use—with special emphasis in Hispanic and African American communities.

Available Funding Levels

Program Outputs

Education for Adults, Teens, and Children

Buckle Up for Life provides all the materials, including props, handouts, and audiovisual aids necessary, for an injury prevention professional to deliver the following one-hour presentations:

  • Adults – this presentation focuses on a crash dynamics, seat belts, distracted driving, and child-passenger safety.
  • Teens – this presentation focuses on crash dynamics, seat belts, and sound decision-making.
  • Children – this presentation focuses on three main topics: the importance of seat belts, where to sit in a car, and proper passenger behavior.

Car Seat Checks and Distribution

Following each educational presentation, certified child passenger safety technicians conduct a car seat check for program participants. During the check they distribute free car seats to parents who requested them.

Minimum Expectations

Ideal partners will provide multiple educational sessions and outreach opportunities to serve as many people as possible, surpassing our minimum required education and seat distribution outputs outlined for each available funding level in the chart above. For example, at a base funding level of $15,000, a partner institution would be expected to distribute a minimum of 100 car seats and would be expected to educate a minimum of 150 people total (children, teens, and adults combined).

Program Outcomes

Applying institutions must indicate in their application (Section 4.D) how they plan to measure program outcomes (behavior change) in their community.

Program Budget

Applying institutions must submit a budget with their grant application, to be approved by Buckle Up for Life. Acceptable program expenditures include salary support, supplies, equipment, mileage, etc. See chart above for available base funding levels. Note that up to 25% of the base funding level may be used for salary support, if needed.

For example, at a base funding level of $15,000, a partner institution would be eligible to receive a total of $17,000—to include up to $3750 for salary support, $11,250 for program supplies and implementation, and an additional $2000 for travel related expenses to the Kidz In Motion (KIM) Conference (Broomfield, CO; Aug-Sept 2017).

Grantee Orientation

Buckle Up for Life Orientation will be offered in conjunction with the Kidz in Motion (KIM) Conference (Broomfield, CO; Aug-Sept 2018). An optional travel stipend (see below) of $2000 above and beyond base funding levels is available to each funded institution to assist with travel-related expenses. Institutions deciding not to travel to the orientation must make up the training session in a mutually agreed upon format at a date and time to be determined. All partner sites are expected to participate in training during the first quarter of the program year.

Optional Travel Stipend

An optional travel stipend of $2000 total (above and beyond base funding levels) is available to each funded institution. This stipend is to be used only to supplement travel related expenses for one or more program staff to attend the Kidz in Motion (KIM) Conference (Broomfield, CO; Aug-Sept 2018) and accompanying BUFL grantee orientation. Covered expenses may include airfare/transportation, hotel/lodging, conference registration fees, meals, etc. Please note: should your institution’s actual travel expenses exceed $2000, the difference must be paid from your own institution’s operating budget. Only the $2000 travel stipend may be applied toward travel expenses; BUFL grant funds from your selected base funding level may not be used for these expenses.


Grantees will submit regular reports to Buckle Up for Life summarizing their progress in outputs and outcomes during the grant year. Midterm and final reports will also include financial summaries.



  • Grants will be awarded to qualified tax-exempt nonprofit organizations, as determined under section 501(c)(3) or 509(a) of the Internal Revenue Code, or to public service agencies (e.g., fire/police departments, local health departments, public schools, etc.).
  • Applying institutions must have an established injury prevention program with a certified child passenger safety technician (CPST) on staff.
  • Applying institutions must have strong partnerships with community leaders. Staff working on Buckle up for Life/Abróchate a la Vida program must have strong social and networking skills.
  • Applying institutions would also benefit from having at least one bilingual (English/Spanish) or multilingual professional on staff.

Required Documentation

Please be sure to complete and upload the following documents as part of your application.

  • Grant Application (can be downloaded below)
  • Budget Template (can be downloaded below)
  • Letter of Support (signed by your organization’s executive leader)
  • W-9 (must be an updated 2018 W-9)

Once you’ve compiled these documents, you may upload them at the bottom of this page.


Frequently Asked Questions                                                             

How do I reach Buckle Up for Life?

Due to high email traffic, applicants are encouraged to familiarize themselves with the contents of the application’s overview and requirements, however, if you need additional information, please direct your questions to

Who reviews my application and how is it weighted against other applications?

The Buckle Up for Life grant is highly competitive, this is why every submission is closely reviewed by an internal committee of injury prevention experts and faculty physicians at Cincinnati Children’s.  This internal committee uses a scorecard approach to assess an applicant’s overall qualifications—taking into account (including, but not limited to) the following:

  • Community’s demographic and socio-economic profile—identifying an at-risk population, with a demonstrated need for this program
  • Organization’s track record of community engagement to address health disparities
  • Organization’s current establishment of a child passenger safety program, with at least one certified Child Passenger Safety Technician (CPST) on staff.
  • Organization’s ability/capacity to meet/exceed minimum education and/or car seat distribution requirements as outlined in Section 4.A of your application
  • Organization’s ability/capacity to track and report outputs and outcomes, in accordance with stated expectations and timelines
  • Organization’s ability/capacity to act as good financial stewards of grant funds
  • Bilingual English/Spanish child passenger safety staff (preferred)

I am a former Buckle Up for Life grantee. Can I apply for a new grant?

Yes, any institution meeting the eligibility requirements—including current and former Buckle Up for Life grantees—may apply for a new grant.  Note: in this case, past performance will be considered during the application review process.

Can I apply for more than one partnership at a time?

No. We encourage applicants to review the detailed descriptions provided for each initiative to determine which partnership would best reflect their needs.

Can I email my application?

No.  All applications must be submitted online through the Buckle Up for Life website, Email applications will not be reviewed.


If you have any questions, please contact:

Buckle Up for Life



We recommend that you fill out this application on a desktop computer. View the form.

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Grant Application 2018
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