Grant Specific Intake Form

Grant Specific Intake Form
Name*

First NameLast Name
Personal Email *
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Personal Phone Number*
Please enter a valid phone number.
Business/Organization Name *
Business Type *
More about the business*
What you do; Who you serve; Intended outcomes/impact
Are you a faith-based organization/house of worship? If yes
Contact Person *

First NameLast Name
Title*
Website*
www.name.com
Facebook URL*
Instagram URL*
X URL*
Phone Number *
Please enter a valid phone number.
Email*
name@name.com
EIN/Tax ID*
Industry*
Years in Operation *
Number of Employees *
Annual Revenue Range *
Funding Need (Size of grants you are looking for ) *
Tell us what you are fundraising for*
What will you use the funds for*
Target beneficiaries of the project*
What kind of funders would you like to see grants from?*
Prior Funding History *
Yes/No - If yes, which programs?
Geographic Focus *
Geographic Focus (Location of Project)*
How Did You Hear About Us *
If Other Please Elaborate *
Nonprofit Status (501(c)(3) Letter Available? *
Mission Statement*
Primary Programs/Services Offered *
Target Audience/Beneficiaries *
Existing Partnerships (if any)*
Past Grants Applied For/Won *
Key Documents Available*

IRS LetterBudgetsFinancialsAnnual ReportAdditional Documents
Key Documents

IRS Letter, Budgets, Financials, Annual Report, Logo, etc.
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