Grant Application Form
Contact Information
Contact Person
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Title
About Your Organization
Name of Organization
*
Legal Name of Organization (if different from above)
Federal Tax I.D. #
*
Does your organization serve residents of Garland County, Arkansas?
*
Yes
No
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Overview of organization:
*
Provide a brief summary of your mission and the need your organization addresses.
How many individuals does your organization serve per year?
*
Website address:
List any social media sites for your organization:
Facebook, Instagram, LinkedIn, TikTok, etc.
Your Grant Request
Minimum grant request: $20,000
Amount requested:
*
Budget for requested funds:
*
Please list the line-item expenses that you are requesting
What needs or problems does this funding address?
*
How many people will you serve through this request?
*
What are expected outcomes or impact of this funding?
*
Description of the target audience:
*
Project Start Date (if applicable)
-
Month
-
Day
Year
Date
Project End Date (if applicable)
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Month
-
Day
Year
Date
Financials
What is your total operating budget for your most recent fiscal year?
*
This is the total amount your organization spent on all of its programs, projects, and administrative expenses in the last fiscal year.
Tell us how your organization receives money throughout the year:
*
Fundraiser events
Individual gifts
Planned giving (gifts arranged in advance like bequests, stocks, or real estate)
Grants from foundations
Grants from federal, state, or local government
Endowment or investment income
Fees for services (ticket sales, insurance reimbursements, membership dues)
Other
If you selected "Other", tell us the other ways your organization receives gifts:
Attach financial information for the previous two years, with audited financial statements, if available.
*
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Please attach a document listing your current board members and their officer positions.
*
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Attach IRS Determination Letter
*
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Attach the most recent IRS Form 990
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Any other relevant supporting documents
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Submit
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