Organization
Organization Name
*
Office Phone Number
*
Organization Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Website
*
Organization (Org) Number
If your Organization has previously received a grant from the Lenz Foundation, please email jsteinberg@fredericklenzfoundation.org for the organization number that you will enter here
Are you a returning grantee?
*
No
Yes
Is your Grant request for a Specific Program or General Support? Please pick one
*
Specific Program
General Support
Primary Contact Name
*
First Name
Last Name
Title
*
Email
*
example@example.com
Phone
*
Grant Secondary Contact
*
First Name
Last Name
Title
*
Email
*
example@example.com
Phone
*
Grant Signatory Contact
*
First Name
Last Name
Title
*
Email
*
example@example.com
Phone
*
Principal Officer or Board Member
*
First Name
Last Name
Title
*
Email
*
example@example.com
Phone
*
How did you hear about us?
*
Please Select
Another Grantee
Current or Former Grantee
Email
Word of Mouth
Web Search
Social Media
Other
Back
Next
Save
Qualified IRS Tax Exempt Non Profit Organization 501c3
*
No
Yes
Letter of Determination from the IRS
*
Browse Files
Drag and drop files here
Choose a file
Only PDF Format Accepted
Cancel
of
History: Provide a history of the Organization including Commencement Date
*
0/200
Mission and Vision
*
Briefly describe the mission and vision of the organization applying for the Grant
0/300
Services Offered by the Organization
*
0/150
Grant Amount Requested ($)
*
Must be between $2,500 and $12,500
2026 Date Funding is Requested
*
-
Month
-
Day
Year
Date
Percentage of funds the Lenz Foundation is being asked to contribute for this Program or General Support
*
Whole Number only - for example - 15 not 15.2
Other Funding Sources
*
0/100
Program/General Description
*
Provide a summary of the Program/General Support Grant including what the program aims to achieve. Highlight its goals and primary activities; specify the timeline and duration, including beginning and completion dates. Who is the target audience? What is innovative about this program? (For program -related grants only)
0/500
Sustainability and Reuse
*
Will the program be repeatable? Is reuse built into the program?
0/400
Description of Impact
*
Describe the short and long-term impact of this Program on your target audience, your community, and beyond. Estimate the number of people impacted short-term and long-term.
0/300
Marketing of Proposed Program
*
How do you plan on marketing the program in order to reach the target audience, how will you disseminate the results of the program?
0/300
Accounting Procedures
*
Provide the procedures your organization will take to segregate the Grant Funds from Operating Expenses
0/200
To what extent is the organization able to utilize the writings, tapes and/or music of Dr. Frederick Lenz (Rama) in the implementation of the program
*
0/150
Short synopsis of the Grant you are applying for
*
This is the version we will use on our website, social media, and promotional materials.
0/70
Budget Detail:
Please list by expenditure category below the proposed grant funds utilization; Expenditure categories may include (as an example), software, website, marketing, retreat expenses, etc. - please note the Foundation does not support the allocation of grant funds for indirect costs such to a supervising administrative unit. Please note that the total of the line item categories must not exceed the grant amount requested.
Line Item 1 Category
*
Line Item 1 Amount ($)
*
Line Item 1 Proposed Expenditure Date in 2026
*
-
Month
-
Day
Year
Date
Line Item 2 Category
Line Item 2 Amount ($)
Line Item 2 Proposed Expenditure Date in 2026
-
Month
-
Day
Year
Date
Line Item 3 Category
Line Item 3 Amount ($)
Line Item 3 Proposed Expenditure Date in 2026
-
Month
-
Day
Year
Date
Line Item 4 Category
Line Item 4 Amount ($)
Line Item 4 Proposed Expenditure Date in 2026
-
Month
-
Day
Year
Date
Line Item 5 Category
Line Item 5 Amount ($)
Line Item 5 Proposed Expenditure Date in 2026
-
Month
-
Day
Year
Date
Line Item 6 Category
Line Item 6 Amount ($)
Line Item 6 Proposed Expenditure Date in 2026
-
Month
-
Day
Year
Date
Line Item 7 Category
Please email line item details that exceed 7 categories to info@fredericklenzfoundation.org
Line Item 7 Amount ($)
Line Item 7 Proposed Expenditure Date in 2026
-
Month
-
Day
Year
Date
Back
Next
Save
Brief description of the staff including their skills and expertise
*
Browse Files
Drag and drop files here
Choose a file
Only PDF Format Accepted
Cancel
of
List Board Member names, titles, and current contact information and their bios
*
Browse Files
Drag and drop files here
Choose a file
Only PDF Format Accepted
Cancel
of
Provide a 2025-2026 organization budget including anticipated grant related expenses
*
Browse Files
Drag and drop files here
Choose a file
For example: salaries, materials, travel, etc. in PDF Format (do not include indirect costs)
Cancel
of
Year End 2023 and 2024 Balance Sheets and Income Statements
*
Browse Files
Drag and drop files here
Choose a file
Only PDF Format Accepted
Cancel
of
Most Recent IRS Form 990 or 990EZ - if available
Browse Files
Drag and drop files here
Choose a file
Only PDF Format Accepted
Cancel
of
Save
Submit
Should be Empty: