2022 Field of Valor Grant Application

Name of Organization *

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Website address *

Name of Executive Director

First Name Last Name

Phone Number

Area Code Phone Number

E-mail *

Other Contact Person's Name

First Name Last Name

Phone Number

Area Code Phone Number

E-mail

$ Amount Requested *

GENERAL QUESTIONS

Is organization a 501 c 3 non profit organization? *

Yes No

Federal Tax ID# *

Please list other organizations that financially support your organization *

What veteran, wounded warrior or family needs are the focus of this organization? *

What specific services, equipment or material does the organization provide that meets those needs? *

What communities or geographic area does the organization serve? *

FINANCIAL DATA

Please provide as much information as you can, which will help us determine the amount of your grant.

Gross Organization Revenue in 2021 *

Gross Organization Revenue to date in 2022 *

Total Organization Expenses in 2021 *

Total Organization Expenses to date in 2022 *

Fundraising Expenditures in 2021 *

Fundraising Expenditures to date in 2022 *

General Op. Expenditures in 2021 *

General Op. Expenditures to date in 2022 *

Total Organization Payroll in 2021 *

Total Organization Payroll to date in 2022 *

# of Employees in 2021 *

# of Employees in 2022 *

Compensation of highest paid employee in 2021 *

Please provide supporting documents for above financial data

INFORMATION ON USE OF FUNDS

Please describe the project's activities and the needs it will meet. Please be as specific as possible. *

How many beneficiaries is this project projected to benefit? *

Expected TOTAL cost of the project *

How much has been pledged or donated to the project to date?

Please list all other organizations or individuals who have made or pledged project donations.

Application submitted by *

First Name Last Name

Signature

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