Grant Application

Contact Information
Name of Person Applying
Name of Organization Applying
(If you are a Indivual applying and not an organization please skip to page 3)
Street Address
City
State
Zip Code
Organization Website
Organization President / Executive Director
Title
Phone Number
E-Mail Address
Contact Person
Title
Phone Number
E-Mail Address

GRANT APPLICATION
Organization Information
501(c)(3)?

Yes No
Year Established
Fiscal sponsor name
Fiscal sponsor address
Total # of Board Members
Total Organization Budget
Total # of Staff
# of Volunteers
Organizational Mission
Description of Organization
Population Served

Proposal Request
Program / Project Name
Total Program Budget
Requested Amount
Type of Request
Multi-Year Request?

Yes No
Geographic Area Served
If the grant is approved what would the money be used for?
Most recent grants received from this funder:
Amount (1)
Date (1)

Month Day Year
Funders Name:
Amount (2)
Date (2)

Month Day Year
Funders Name:
Signature

Clear
Enter the message as it's shown *
Should be Empty:

Now create your own Jotform - It's free! Create your own Jotform