Grant Application Form

Grant Application Form

Please complete this application to be considered for NBN GRG funding. Answer each section carefully and thoroughly.
Section 1: About Your Group

Tell us more about you and your group / organization
Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Organization / Group Name*
Do you have an EIN?*

YesNo
Do you have 501(c)3 tax-exempt status?*

YesNo
Mailing Address*

Street Address

Street Address Line 2
CityStateZip Code
Year your group was established*
What is your group's mission?*
Please list the names and addresses of at least 3 group members from different households.*

Name

Address

NameAddress

Postal / Zip Code
Name

Address

NameAddress

Postal / Zip Code
Name

Address

NameAddress

Postal / Zip Code

Section 2: Your Project

Tell us about the project you are proposing.
Project Title*
What grant focus area does your project fall under?*

Civic EngagementEconomic MobilityEquitable Development
What neighborhood will your work take place in?*
Where specifically will this project take place? (venue/location)*
Why is this project needed right now? *
What challenges or events led you to submit this proposal?
Describe your project*
What activities will take place, who will be involved, and how will it be implemented?
What is your estimated project timeline?*

Section 3: Outcomes & Capacity

Help us understand your project's goals and your group's capacity.
What are up to outcomes you plan to achieve with this project?*
Why is your group equipped to take on this project?*
Is there anything else we should know about your group or project?

Section 5: Confirmation

Final steps to confirm your application.
I confirm that at least 3 residents from different households are committed to leading this effort.
Signature (please sign below)*
Date*

MonthDayYear
Date
Should be Empty: