Community Agency Grant Application
Please fill out the form completely. You can expect a reply within 5 business days.
What is the legal name of your agency?
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Is your agency a Florida not-for-profit corporation
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Yes
No
What is the IRS designation for your corporation? ie: (501(c)3; 501(c)4
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What is the physical address of your agency?
*
Who is your chief executive officer (name and title)
*
Who will act as contact person for the evaluation process?
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
What percent of your total budget is spent on administrative overhead and marketing (fundraising)?
0 - 10%
11%-25%
26% - 50%
51% - 74%
75% - 100%
How does your current budget compare to the last three years? (Explain growth or decline). Please limit your response to 250 words or fewer.
Accountability and financial transparency
Please describe the process your organization uses to report its financial information? Please limit your response to 250 words or fewer
Impact on the community
Describe the goals of your organization: Please limit your response to 250 words or fewer.
What progress is your organization making towards its goals? Please limit your response to 250 words or fewer.
How has the community benefited from your organization's goals? Please cite specifics. Limit 250 words.
In the Pinellas community, are there other organizations with similar goals? If so, how many? Limit 250 words.
Currently, what are the sources of the organization's income? Please limit your response to 250 words or fewer.
Value Proposition
Please tell us anything else you want us to know about your organization. Please tell us (in general terms) what the grant will be used for. Limit 500 words.
Submit
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