ACTC Grant Application

2026 ACTC GRANT APPLICATION
Organization Name
Organization Also Known As
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is Your Organization 501(c)(3) Tax Exempt?

YesNo
Non-Profit Incorporation Date
Total Fiscal Summary
Organization Budget for Last Completed Fiscal Year:
Organization Budget for Present Year:
Organization Budget for Projected Year:
Financial Documentation

Applicants must provide the following current financial reports: 1). Year-to-Date P&L Statement 2). Current Balance Sheet 3). 2024 Profit & Loss Report 4). Most recent filed IRS 990
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Applicant Contact

First NameLast Name
Title
Phone Number
Please enter a valid phone number.
Email Address
example@example.com
What have you accomplished this last year?
ACTC Grant Agreement
Under penalties of perjury, I declare that I have examined information contained in the application for this grant and accompanying documents and, to the best of my
knowledge and belief, they are true, correct and complete, and I am in fact eligible for funding under this grant program. I am aware that the submission of any false information or omission of any pertinent information resulting in the false representation of a material fact may subject me to civil and/or criminal penalties for filing of false public record and/or forfeiture of any funding awarded under this program. I further declare that I have reviewed the ACTC Overview Guidelines and acknowledge my responsibility as a grant applicant to become familiar with these guidelines and that failure to comply could result in ineligibility for the grant program now and in the future.

I understand that should I have any questions regarding these guidelines, I may contact ACTC. I further understand that all documents submitted become the property of ACTC.
Full Name
Title
Initial
Date

MonthDayYear
Date
Should be Empty:

2026 ACTC GRANT APPLICATION

Total Fiscal Summary

Financial Documentation

ACTC Grant Agreement