Palmer Home Foundation Grant Application
Please fill in all required items below. You will receive a confirmation email with your responses upon completion. Thank you for your commitment to helping seniors in Kent County.
Organization Name
*
Contact Name
*
First Name
Last Name
Title
*
Phone Number
*
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Director / Administrator
*
Statement Of Agency Purpose And Population Served
*
List of Current Board members including their city and state of residence
*
Optional: Upload Your List of Current Board Members
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Required: Charitable Status (Please submit your IRS Letter/Document - Must be .pdf, .doc, or .docx) Copy
*
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Amount of Funds Requested
*
Description Of Use Of Proposed Funds (Please Be Specific)
*
List all other grants, including source and amounts applied for and received in the last 12 months
*
List two community references, one of whom receives direct benefit from your organization
*
Percentage of requested funds to be used for Administrative costs
*
Please explain what constitutes administrative costs as it relates to your organization and how much of Palmer Home Foundation Funds are spent for Administrative Costs:
If Applicable / Additional Supporting Documents
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I hereby state that the above information is true to the best of my knowledge.
*
Please verify that you are human
*
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