Grant Application

Grant Report
Before you begin, please review the Reporting Guidelines by visiting the link below and checking the appropriate box after reviewing:
Full Legal Name of Reporting Organization:*
Today's Date:*

MonthDayYear
Date of Award Letter:*

MonthDayYear
Grant Number:*
Amount of Awarded Grant:*
What type of funding was this:*
Tax ID/ EIN:*
What was the specific Project or Program name that funding was requested for?*
Which state did this grant benefit?*

FloridaNew YorkWashington, DCConnecticutOther
Approximately how many people benefited from this grant:*
What difference has this grant made to the people and services you support?*

These details should include, but are not limited to, (1) the extent that the original goals and objectives were achieved, (2) how the project or program impacted the community and/or your target population, (3) future plans for the project or program, (4) unexpected obstacles or outcomes good or not so good and, (5) any additional information you think the Board would need to know or enjoying learning about.0/1000
How does your organization propose to provide adequate funding for this project in the future, and what are the next steps in the program or project's development?*

0/500
Contact Person*

First NameLast Name
Title*
Contact Person E-Mail Address*

Confirmation Emailexample@example.com
Contact Person Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Have there been any significant changes, internal or external, to your Organization or has the status of your 501(c)(3) designation changed since the date of the award letter?*

YesNo
Please explain in detail what has changed:*
What best describes the initiative that this funding was used for?*

Performing ArtsVisual ArtsLearning and ImpactVeterans InitiativesHealth and Human ServicesOther
Additional Organization Specifics
Organization Website:*
Organization President/ Executive Director*

First NameLast Name
President/ Exe. Dir. E-Mail Address*
example@example.com
President/ Exe. Dir. Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Organization's Mission Statement:*
Please only submit your actual Mission Statement.
Before your report is considered complete, please remember to submit grant-related photos using the appropriate link at the bottom of the Grant Reporting Page.
Should be Empty:

Grant Report

Before you begin, please review the Reporting Guidelines by visiting the link below and checking the appropriate box after reviewing:

Additional Organization Specifics