Concordia Action Alliance Grant Application

Mission Statement (150 words maximum)*

0/150
Organization size (number of employees)***
Operating budget***
Partner Organization Information
Legal Name*
Country Headquarters
Point of Contact*

First NameLast Name
Role/Title*
Email*
example@example.com
Have you partnered with the entity in the past?***

YesNo
**Will not influence grant determination, but helpful for Concordia to track the type of organization pursuing grant opportunities!

Request Details
Proposal description (250 words maximum)*

Please include: - main + all secondary partners - anticipated geography of project - how funds will support partnership formation - what additional funds might be needed - any innovative features of the partnership
0/250
Expected outcomes of Alliance Action Fund grant*
Amount of funding requested ($5-$20K)*
Usage of requested funding*

Upload spreadsheet with the following information for each usage line item: (1) line item name, (2) amount of funding used, (3) notes/comments
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Expected outcomes of overall partnership*
General project timeline*
General project funders*
(list identified / secured funding, or detail regarding project financing that may be useful to decision makers)
Monitoring and evaluation process*
Supporting Materials*

Please submit the organization's audited financial statements for 2019 and 2020.
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Should be Empty:

Grant Application