Please confirm your funding eligibility.
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My organization is a nonprofit, government agency, school, or public safety district.
My organization is located in or serving Humboldt, Del Norte, or Trinity Counties.
My organization is requesting funding for equipment, a repair, or a community enhancement.
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Project Overview
Program/Project Name
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Total Project Cost
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Amount Requested
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Which focus area does your project support?
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Please Select
Healthcare
Animal Welfare
Public Safety
Basic Needs
Which type of need does your project address?
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Please Select
Equipment
Community Enhancement
Repair
Contact Person
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Organization Information
Legal Name of Tax Exempt Organization
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Letter of Tax Exemption (e.g. 501(c)(3) letter)
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Mailing Address
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Street Address
Street Address Line 2
City
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State
Zip Code
Executive Officer
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Project Details
What specific equipment, repair, or community enhancement will this grant fund?
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How will this project help your organization better serve those you already serve well?
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0/250
What happens to this project without our support?
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0/250
Is this project part of a larger effort? If so, briefly describe it.
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0/200
Project Budget
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Please use our provided
budget template
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Vendor Quotes/Estimates
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Please furnish copies of any vendor quotes or estimates referenced in the project budget.
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