UWNC Emergency Response Fund (COVID-19)

UWNC COVID-19 MITIGATION SUPPORT GRANT
(COVID-19 RELIEF - NON-ERI)

**ALL fields are required**
Amount Requested
Organization Name
Organization EIN:
(Format: XX-XXXXXXX)
Executive Director Name

First Last
Organization Address

Organization

Street

City State / Province

Postal / Zip Code Country
Organization Phone
Grant Contact Name
Grant Contact Phone
Grant Contact E-mail
Please explain how COVID-19 has affected your agency's income & expenses - from the pandemic's beginning to now:
Please explain how this grant will be used to respond to the COVID-19 public health emergency:
Please explain what information/data/evidence you will use to demonstrate this grant aided in your organization's successful response to COVID-19:
What other funds are supporting this project? (Donors, Organizational Reserve, SBA, PPP, etc)
Program Name
Total Program Cost
Program Budget

Browse Files
Please upload PDF copy of your program budget that outlines the anticipated income and expense for the entire project. Cancel of
501(c)3 Letter

Browse Files
Please upload your NPO status letter from IRS. Cancel of
Should be Empty:

UWNC COVID-19 MITIGATION SUPPORT GRANT