Grant Application Form
Name of Applicant
*
First Name
Last Name
Your Title (Optional)
Preferred Email
*
example@example.com
Organization Represented
*
Purpose of Organization
*
0/100
Please attach (or link below) information about your organization:
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Link to information about your organization:
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
503(C)(3) Tax Exempt ID#
*
Tax Exempt ID Held By
Public Charity
Private Foundation
Governmental Organization
Religious Organization
If Applicable, Sponsoring Tax Exempt Organization Information
Address, Telephone Number, E-mail, and Contact Person
This section should only be filled out if your organization is not tax exempt and is being sponsored by a tax exempt organization
If there is a sponsoring organization, please attach a letter from that organization regarding its willingness to sponsor
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Date of Submission
*
-
Month
-
Day
Year
Date
Purpose of Application (please be specific)
*
0/1000
Total Amount Needed for the Project
*
$
Amount Requested from the Foundation
*
$
Where will the remainder of the funding come from?
0/100
Date for Completion of Project or Purchase of Item
*
Please attach a specific itemization of costs with copies of catalog or website pages or estimates from companies performing the work.
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General estimates are not appropriate, we need exact model at exact price.
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If you have any additional relevant files, please attach here:
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