ORGANIZATIONAL INFORMATION.2021

Contact Information for new grant applicants
Full Legal Organization Name *
Street Address
City
State
Zip Code
Organization Website
Organization President / Executive Director
Title
Phone Number
E-Mail Address
Contact Person
Title
Phone Number
Contact person E-Mail Address
Organization Information
501(c)(3)?

Yes No
Year Established
Fiscal sponsor name
Fiscal sponsor address
Total Organization Budget
Total # of Board Members
Total # of Staff
Total # of Volunteers
Organizational Mission Statements
Brief Description of Organization
Population Served
Should be Empty: