2026 NCBA Mini Grant Application
Environmental Justice Issues
Organization Name:
*
EIN:
*
Mailing Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization Contact Name:
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Mini Grant Contact Name:
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Financial Information Contact Name:
*
First Name
Last Name
Financial Information Contact Email:
example@example.com
Do you have a Fiscal Sponsor?
*
Yes
No
If yes, please provide the name of the organization below:
*
Fiscal Sponsor EIN:
*
Fiscal Sponsor Contact Name:
*
First Name
Last Name
Fiscal Sponsor Email:
*
example@example.com
Fiscal Sponsor Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Fiscal Sponsor Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Amount Requested (Up to $10,000)
*
Description of Project (2-3 Paragraphs):
*
No more than 2-3 paragraphs
Provide a list of activities, trainings, events, etc. proposed:
*
Provide a list of key partner organizations that will assist in completing this project:
*
A requirement for this cohort is attending the annual Environmental Injustice and Healthcare Summit. Are you able to commit to this requirement?
*
Yes
No
Terms:
All projects should be initiated in 2026
You must have an EIN number and bank account for your organization
You will need to set up a profile in Gusto for direct deposit
A
Grant Update Report
will need to be submitted no later than
May 31, 2027
Send your request to
jovita@ncblackalliance.org
,
brayndon@ncblackalliance.org
and
dlester@ncblackalliance.org
Feel free to reach out with any questions.
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