Organization Information
Organization Name
*
Address
*
Street Address
Street Address Line 2
City
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Alabama
Alaska
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District of Columbia
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Ohio
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South Carolina
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Tennessee
Texas
Utah
Vermont
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Wisconsin
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State
Zip Code
Phone Number
*
-
Area Code
Phone Number
Website
Executive Director
*
First Name
Last Name
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Proposal Contact Information
Proposal Contact
*
First Name
Last Name
Organization Title
*
Please enter your organization title.
Email Address
*
Phone Number
*
-
Area Code
Phone Number
Organization Background
Tell us about your company.
Is your organization a 501(c)3/non-profit?
Yes
No
Year Established
*
Total # of Staff
Total # of Volunteers
*
0-25 | 25-50 | 50-100 | 100+
Organizational Mission & Primary Activities
*
Brief Description of Organization
*
0/150
Geographic Area Served/Community Location
*
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Proposal Information
Program/Project Name
*
Program/Project Description
*
0/250
Project/Program Constituent Ages
0-10 Years Old
11-15 Years Old
16-18 Years Old
Ages Over 18+
Total Program Budget
*
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Attach any budget supporting documentation.
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Requested Grant Amount
*
Athletic Equipment Donation Request
If your grant request includes non-monetary athletic equipment needs, please detail the specific items requested here.
Program/Project Administrator Name
*
First Name
Last Name
Youth Impact
*
Approximately how many youth will be directly impacted by the program/project?
Type of Request
Capital Campaign
Capacity Building
General Operating
Multi-Year Project
Program Support
Start Up
Requested Grant Period From Date
*
-
Month
-
Day
Year
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Requested Grant Period To Date
*
-
Month
-
Day
Year
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Multi-Year Grant Request?
Yes
No
Project/Program Objectives
*
0/250
Project/Program Impact Measurements
*
How will your organization measure the impact/success of the project/program?
0/250
Sustaining Project/Program
*
How will your organization sustain the project/program activities in the future?
0/150
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Other Information
Previous Mattingly Charities Grants
*
Please list all previous Mattingly Charities grants awarded to your organization, including the project/program dates and grant amounts. Enter N/A if this does not apply to your organization.
Referred By
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