If this is the first time for your organization requesting a Grant, please fill out the form below. If your organization has been funded in the past by the Foundation, bypass this form and please proceed directly to the New Grants form instead.
Contact Information
Your Name:
Organization:
Email Address:
Phone Number:
Address:
City:
State:
Zip Code:
Organization Mission
What is your organization's mission statement?
What is the history of your organization?
What are your organization's accomplishments?
Who are your board of directors and what are their professional affiliations?
Project Request
What is the purpose for this request?
What amount are you requesting for this project? $
When are these funds needed?
Do you have a list of other funding sources for this request? Yes No
Requirements Necessary to Proceed with Funding Request
Do you have a current 501(c)(3) designation from the IRS? Yes No
Are audited financial statements available? Yes No
Do you have available an operating budget for your organization? Yes No
Do you have a project budget specific for your grant request? Yes No
Do you have a list of major funding sources and the the dollar amounts for the past two years for your organization? Yes No
Evaluation Plan
What outcomes do you hope to accomplish with this grant?
