Grant Application

Grant Application

Complete the application and upload the required attachments to submit your proposal request.
Contact Information
Date of Application

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Tax ID
Legal Name of Applying Organization
Year Founded
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Organization Website
Executive Director/Organization President

First NameLast Name
Title
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Contact Person (if different)

First NameLast Name
Title
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Proposal Request
Project Name
Purpose of Grant
Amount Requested
Total Project Cost
Will you accept partial funding?
Is your organization a 501(c)(3)?
Geographic Area Served
Time Frame for Project
Budget Format
Below is a listing of standard budget items. Please provide the project budget in this format and order.
Organization's fiscal year
Time period this budget covers

Expenses: Include the total amount for each of the categories in the table below.

Rows	Amount Requested	Total Project Expenses
Salaries
Payroll Taxes
Fringe Benefits
Consultants/Professional Fees
Insurance
Travel
Equipment
Marketing
Occupancy Cost (rent, utilities, Maintenance)
Office Expense (supplies, copier, phone, postage)
Capital Improvement Budget

Revenue