Journalism Grant Application
Organization Name
*
Enter Legal Name of the Organization and/or DBA
Contact Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
Website URL
(If applicable)
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
501c3 Tax Exempt Status
*
Yes
No
Upload copy of 501c3 letter
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Organizational Information
Mission Statement and History
250 Word Limit
0/250
Total Organization Budget
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Budget should reflect the total percentage of program, operation, and fundraising expenses
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Upload Most Recent 990
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Number of people served per year
Programming Information
Program Name
*
Name of the program for which you are requesting funding
Geographic Area Served
Please indicate cities and states
Number of people served in this specific program
Program-Specific Budget
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Include the program specific budget including a descriptive justification for each expense and the salary allocation (FTE) of each staff to each program including volunteer hours
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Total Funds Requested
What issues or concerns does this program target?
How will you use the funds to address the issues or concerns?
What are the goals of the program?
Please note that all programs funded by NBO are required to submit an after action report on how the program preformed against its stated goals.
How will the success of the program be measured?
Demographics
Racial/Ethnic Population Served
Socio-Economic Demographic Served
Male/Female/Transgender population served by percentage
If the gender gap is larger than 50% please explain the reason. If applicable explain what you are doing to bridge the gender gap
How does the above population compare to the community at large in which your program operates?
Comments
Please verify that you are human
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