2026 Spring Impact Grant

2026 Spring Impact Grant Application
Grant requests for $5,000 or below will not be considered for this grant cycle. You can submit applications for up to 3 programs. The requests must be in 3 separate applications. Total funding requests (for all 3 programs combined) must not exceed $35,000.
Today's Date*

MonthDayYear
Date
Organization Name*
Legal Name (If Different)
EIN#*
Physical Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address (If Different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Organization Phone Number*
Please enter a valid phone number.
Agency Website Address*
Executive Director's Name*

First NameLast Name
Executive Director's Email Address
example@example.com
Name of Person Completing Form*

First NameLast Name
Contact Email*
example@example.com
Phone Number
Please enter a valid phone number.

About the Program
Program Name*
Program Description*
Amount Requested For This Program*
Which United Way focus area does the program fall under? Pick one*

Healthy Community - Improving health and well-being for allYouth Opportunity - Helping young people realize their full potentialFinancial Security - Creating a stronger financial future for every generationCommunity Resiliency - Addressing urgent needs today for a better tomorrow
Which Counties does your program serve. Check all that apply*

Faulkner CountyPerry CountyVan Buren CountyConway County
Demonstrate how your program aligns with the above focus area.*
Program Timeline*
What "Specific Need(s)" is being addressed by your program*
Total Number of Individuals being served by program*

Program Budget
Upload your Program Budget*

*This is not your agency budget, this is specifically for the program you are applying for.
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What will the grant funds be used for?*
What is the minimum amount you will need to fund this program?
Matching Funds (In-Kind & Paid Partners) Describe the percentage or amount of matching funds.
Describe your plan to make this program sustainable long term:*

Agency Activity
Is your registration with the Arkansas Secretary of State up to date?*
Not sure? Click the link to check your SOS status! https://www.ark.org/corp-search/index.php
Are you compliant with all applicable anti-terrorist financing and asset control laws as outlined by the Federal Patriot Act?*
Were your able to pay all regular operational expenses within 60 days of thedue date during the last year?*
Is your 501(c)3 Tax Exempt Status in good standing with the IRS?*
Please explain If you answered "No" to any of the above questions.
Were any grant awards of any kind withheld from your agency, either in partial or in full last year?*
Did your agency operate in a deficit in the last fiscal year?*
Please explain If you answered "Yes" to any of the above questions.

Required Documents
Upload a copy of the most recent IRS Determination Letter*

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Upload your most recent 990*

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Please upload a copy of your overall agency budget*

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Upload your most recent Financial Audit/Review*

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Upload your Board of Directors Roster*

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Upload your Non Discrimination Policy*

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Non-Discrimination Agreement:

Agency program partner agrees that agency clients, staff and membership on the governing board are served, employed or appointed without regard to social or economic class, gender, gender identity, age, sexual orientation and identification, disability, special health care needs, race, color, national origin or religion. Organizations with a religious affiliation must not refuse services to an applicant based on religion or require attendance at religious services as a condition of assistance.
Signature*

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2026 Spring Impact Grant Application