Grant Services Information
Name
First Name
Last Name
Title/Position at Your Organization
Organization Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
What is/are your preferred method(s) of communicating?
Email
Phone
Zoom
Other
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County
Website
Candid Profile (if applicable)
Year Incorporated
Fiscal Year Start and End Dates (i.e., January 1-December 31)
Annual Operating Budget
List of specific funding needs and amount needed for each.
Mission Statement
Vision
Values Statements
Target Population
Number Served in Previous Year
Number of Full Time Paid Staff
Number of Part Time Paid Staff
Number of Volunteers
Geographical Service Area
Organization History
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Current Programs/Services Detailed Descriptions
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Project/Program Logic Models (if applicable)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Tax Exempt Status Letter/IRS Determination Letter
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Most Recent IRS Form 990
Browse Files
Drag and drop files here
Choose a file
Cancel
of
W-9
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Dun & Bradstreet Number (DUNS; if applicable)
SAM Registration Number (if applicable)
Detailed Organizational Budget (Current Fiscal Year)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Detailed Organizational Budget (Previous Fiscal Year)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Most Recent Audit or Review
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Program/Project Budgets (for current fiscal year for each program, multiple files allowed)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Sources of Funding (for last three fiscal years; please use this template, download to complete, and upload here: https://docs.google.com/spreadsheets/d/1Dli-xJJ4zR3jYbqHm0F-lkokxCJZwyzJx9vm81F1MVA/edit?usp=sharing; if you have this information available in a different format, please feel free to upload that instead)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
What percentage of your overall budget is derived from each of these sources?
Voided Check
Browse Files
Drag and drop files here
Choose a file
Cancel
of
What percentage of your Board members contribute financially to your organization?
Board of Directors List (including affiliations, titles, terms, and length of service)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please describe your Board selection process and term limits.
Articles of Incorporation
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Bylaws
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Most Recent Strategic Plan (if applicable)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Organizational Theory of Change (if applicable)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Organizational Chart
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Top 5 Highest Paid Employees
Executive Director Bio
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Program Evaluation Plans (if applicable)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Current Outcome Measures (i.e., how are you measuring success?)
Outcomes from Previous Year
Job Descriptions (multiple files allowed)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Resumes/Bios of Key Staff (multiple files allowed)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Success Stories
Policies/Procedures Manual (if available)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
List collaborating partners and the nature of each partnership.
Please upload any contracts or memorandums of understanding (MOUs) for existing partnerships.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Data and/or statistics describing the need you are addressing.
Please share some examples of previously written grants. The more diversity in the examples, the better (i.e., grants written for different programs, to different types of funders, etc.). (multiple files allowed)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please upload a Word document file of your company letterhead.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
If comfortable, please upload digital signature(s) for anyone who would sign an application or letter (multiple files allowed). Please note that uploading digital signatures is considered providing consent to use said signatures for organizational grant purposes only. Digital signatures will not be used for any other purpose.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Has your organization received any awards? Please list award name, presenting organization, and year received.
Anything else you'd like to share that you think may be helpful.
Submit
Should be Empty: