Russell Hill Rogers - Grant Application 2023

Application
Name Doing Business As*
Legal Name (as on determination letter)*
Tax ID#*
Name of organization’s Executive Director or Head of Administration
Organization Name (to whom the check should be made out to)*
If grant is awarded
Title/Position*
Contact Phone Number*
Format: (000) 000-0000.
Contact Phone Extension
Contact Email*
example@example.com
Mailing Address (Where the Check Will be Mailed)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County/Counties where services are provided*
Project Information
Project Name*
Expected Audience Numbers*
Proposed Event Date(s)
Project Venue*
Amount of funding requested*
Project Description - Please describe your project in a paragraph below.*
Other current and potential sources of funding for the project
Source*
Amount Requested*
Amount Received to Date*
A list of the current Board of Directors and their affiliations*
How will the RHRFA name be recognized?*
Organization Operating Expense
Total Annual Operating Expense*
Total Payroll Expense*
Number of Paid Employees*
Organization Revenues
Total Annual Revenues*
Top Five Revenue Sources*
Itemized Project Budget*

Cancelof
Copy of the organization's IRS Tax-Exempt Determination Letter*

Cancelof
Most recent financial statement and income-and-expense budget for the organization*

Cancelof
ONLY Parts I, II and III of the most recent Form 990 submitted to the IRS; the 990 in its entirety is no longer required*

Cancelof
All applicants will receive an email confirmation of receipt once the application has been submitted for consideration.
Should be Empty:

Application

Project Information

Other current and potential sources of funding for the project

Organization Operating Expense

Organization Revenues