Agency/School Grant Application

Autism Alliance of Northeastern NY will provide small grants of up to $500 to agencies, schools, and organized groups. Requests can include, but are not limited to, the purchase of sensory equipment, technology, curriculum, or materials needed for social groups.

Requests must meet the following criteria:
- Funds must directly benefit people with autism.
- Applications must include quotes and documentation as appropriate.
- Requested funds must not exceed $500.
- All quotes must be used for direct program costs. Administrative expenses will not be funded.
- Applicants must provide service within Clinton, Essex, or Franklin County.
- Applicants must allow Autism Alliance of Northeastern NY to publicize the award.
In addition, please be aware of the following:
- Autism Alliance of Northeastern NY is not bound to approve funds for all grant applicants. We reserve the right to choose agencies that embrace our mission. We also reserve the right to deny a grant application or provide partial funding.
- Preference may be given to those that have not previously received funding from Autism Alliance of Northeastern NY.
- Applications from non-profit organizations will be given priority.
  - The review process may take several weeks. You will receive an email with a decision. If you have any questions, please contact us at grants@aaneny.org or 518-219-0855.
Agency/School Grant Application
Agency/Organization Name
Address

Street Address

Street Address Line 2

City, State, ZipState / Province

Postal / Zip Code
Contact Person
Title
Phone Number
Email
example@example.com
No

Is this a 501(c3) not-for-profit organization?Yes
Geographical area served
How did you learn about this grant?
Project Name (if applicable)
Project Budget
Total Amount Requested (please attach itemized request)
No

Have you previously applied for a grant from Autism Alliance of Northeastern NY?Yes
If yes, please provide details.
If the grant is denied or funded in part, will you move forward with this project? Please explain. Will you seek funding from other organizations? If so, which organizations?
Please provide a summary of your Grant Request, including overall goals and objectives (short term and long term), how many people will benefit, how they will benefit, how this project furthers our mission, etc. Attach additional sheets if needed.
By signing below, I certify that all information is true and correct to the best of my knowledge.
Printed Name and Title
Date

MonthDayYear
Date
Signature

Clear
Should be Empty: