UTN CAP Application

UTN Community Assistance Program (CAP) Application

Overview: UTN is a 501(c)3 public charity that supports service minded individuals and community-based organizations working to empower Black and Brown communities and spaces (Tax ID: 47-7217609).
Community Assistance Program (CAP) Grant Awards: $500+

Eligibility: Nominees must be:

1) a service-minded student at an accredited community college or university,

2) a community activist/artivist or

3) a community based organization (CBO)

Application Requirements:

1. Fill out the application form completely, electronically sign and SUBMIT.

2. Must have donated at least $20 to UTN in the last six months.

NOTE: UTN considers donation and award requests on a continual basis, with funds awarded biannually.
Section 1: Please provide your contact information in this section and answer the required questions.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Have you donated at least $20 to UTN during the previous six months?*

YesNo
Best ways to communicate with you?*

CallTextEmail
If nominee is selected, do you want to remain anonymous?*

Yes, please do not include my name in award letter.No, you can include name in award letter as "nominated by...."
Section 2: Please provide information on the person or organization you are nominating for a UTN CAP award in this section.
Nominee’s Name (person or CBO) *
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please provide a short description of the nominated person or organization and why you are nominating them. Include how the person or organization promotes one (or more) of the 4 pillars of UTN: cultural literacy, community activism/artivism, media literacy and/or reciprocity.*
Amount Requested:
Application Date*

MonthDayYear
Date
Electronic Signature Certification: I herby certify that the information I have submitted is correct. I authorize the release of this information to TRUSTEES of UTN and will provide additional information or verification upon request. REMINDER! SIGN BELOW and then click the SUBMIT button to complete the application.*

Clear
Should be Empty:

UTN Community Assistance Program (CAP) Application

Section 1: Please provide your contact information in this section and answer the required questions.

Section 2: Please provide information on the person or organization you are nominating for a UTN CAP award in this section.