GCAC GRANT APPLICATION
The mission of the Garden Club of Allegheny County shall be to promote greater knowledge of horticulture, stimulate interest in conservation and historic preservation, encourage community and environmental education, and participate in civic planning and planting programs.
Grant form revised October 2024
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General Information
Organization Name
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Mailing Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization Website
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Program or Chapter Website
Organization Mission Statement
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Is this application being made by a stand-alone nonprofit organization
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Yes
No
Is this application being made by an organization that is part of a larger nonprofit/parent organization?
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Yes
No
Name of parent organization, if applicable
GCAC Member sponsor
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Relationship of sponsor to the applicant organization
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Executive Director
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First Name
Last Name
E-Mail Address
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example@example.com
Work Phone
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Please enter a valid phone number.
Cell Phone (optional)
Please enter a valid phone number.
Project Director
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First Name
Last Name
Projector Director Title
*
E-Mail Address
*
example@example.com
Work Phone
*
Please enter a valid phone number.
Cell Phone (optional)
Please enter a valid phone number.
Person completing this application
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First Name
Last Name
Applicants Title
*
E-Mail Address
*
example@example.com
Work Phone
*
Please enter a valid phone number.
Cell Phone (optional)
Please enter a valid phone number.
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Organization and Project Information
Project Title and Brief Description (75 words or less. A longer description will be entered later.)
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0/75
Grant Request Amount
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IRS tax number for organization or, if applicable, parent organization
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Is your organization registered with the Pennsylvania Bureau of Charitable Organizations?
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Yes
No
What is the most recent annual operating budget for your organization or, if part of a larger organization, that of your program or chapter?
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Year and dollar amount
If applicable, what is the most recent annual budget of the parent organization?
Year and dollar amount
Number of employees (if part of a larger organization, include only your program or chapter, not the entire organization)
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Has your organization (or parent organization, chapter or program) received previous grants from GCAC? If yes, list the years and project titles
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Brief History of Organization or Program (75 words or less)
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0/75
Description of the Project for which funds are being requested. Include in the description of the project: a) the project's history, b) purpose, c) the target population served, d) location(s), e) challenge or opportunity addressed, f) anticipated outcomes, g) anticipated challenges, h) plan for sustainability (3-6 years out), i) how it fits the mission of GCAC. (500 words or less)
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0/500
Timetable and Benchmarks for completion
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Project Income
List all sources of income for this project including but not limited to: individuals, foundations, corporate/business, internal and/or parent organization, government, endowment, other (specify), and GCAC request. Please identify whether the funds have been raised, committed or anticipated. You may add rows as needed.
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Project Expenses
You may add rows as needed. Use NA when appropriate.
Project Staff, list by position (calculate the amount entered based on annual salary including fringes or hourly wages including fringes, and please specify which)
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Outside Contractors or Consultants
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Materials
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Equipment
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Other
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Additional notes that might be helpful
TOTALS
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Required Attachments
Upload PDFs of the following required items.
Copy of current year operating budget. If part of a larger organization, include only your program or chapter's budget, not that of the entire organization.
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Copy of your most recent audited financial statement. If part of a larger organization, provide a copy of the previous year's actual financials for your program area, division, or chapter for the last completed fiscal year.
*
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A list of current Board of Directors
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Other supporting PDF if appropriate
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Name and Title
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I, hereby attest the information provided is correct. (use cursor to sign name)
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Date Signed (mm/dd/yyyy)
*
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