READ AND COMPLETE ALL APPLICATION INSTRUCTIONS BEFORE SUBMITTING YOUR GRANT REQUEST
Submit one complete, typed, and secured application with
a cover page
Applications sent by fax will not be considered for funding
Applications that are not correct and complete will not be
considered for funding
Applications should not be submitted more than 30 days prior to the deadline
date and must not be post marked after the deadline date.
Applications must be submitted via USPS.
Name of Organization
Address (mailing & physical, if they are
main office (verify that you are requesting funding during the correct funding cycle for your county)
Name of Executive Director
Name of Contact Person
Phone Number of Contact Person
Email of Contact Person
Federal ID Number
PART A: BRIEF STATEMENT OF REQUEST
Briefly describe the proposed project and how much money is being requested.
Include the total budget of the project.
PART B: INFORMATION ABOUT YOUR ORGANIZATION
Background and/or history
Your mission or purpose
PART C: PROJECT DESCRIPTION
Explain the specifics of the project and justify the need
Prepare a timeline for implementation of the project
PART D: FINANCIAL
Project budget -
a breakdown of the dollars, how they are to be spent
and Annual Auditor's Report. If the Annual Auditor's Report
is older than 12 months, include an Income/Expense Report and Balance Sheet for the last 12 months.
DO NOT SEND THE 990 TAX RETURN
request is for an on-going project, include how funds will be raised to continue the project in the future.
PART E: ATTACHMENTS
Copy of the Treasury
Authorization Letter (from the IRS)
List of Board
of Directors and brief profile