Grants

GRANT APPLICATION

Date of Application:

Legal name of organization applying:

Year Founded:

Current Operating Budget:

Executive Director:

Email Address:

Contact person / title / phone number: (if different from executive director)

Address (principal / administrative office):

City / State / Zip

Phone Number: (include area code)

Website:

Purpose of Grant (one sentence):

Date of the Project:

Amount Requested: $

Total Project Cost: $

Geographic Area Served:

Signature, Chairperson, Board of Directors

Typed Name and Title

Date

Signature Executive Director

Typed Name and Title

Date

Attached Additional Documents (Ex. Organization Information and Executive Summary documents)

Please provide the following information in this order. Use these headings, subheadings and numbers provided in your own word processing format, thus leaving flexibility for length of response.

A. NARRATIVE

1. Executive Summary

Begin with a half page executive summary. Briefly explain why your agency is requesting this grant, what outcomes you hope to achieve, and how you will spend the funds if the grant is made.

2. Purpose of Grant

Needs Assessment
Describe the specific needs or challenges the project aims to address. Include a profile of the target population
and explain how they will directly benefit from the proposed activities or services.
Project Overview
Provide a clear description of the project’s goals, measurable objectives, and detailed action plans. Indicate
whether this initiative is a new effort or an extension of an existing program within the sponsoring organization.
Implementation Timeline
Include a proposed timetable outlining key phases and milestones for project implementation.
Collaborating Partners
List any partner organizations involved in the project and describe their specific roles and contributions.

3. Organization Information

Brief summary of organization’s history.
Brief statement of organization’s mission and goals.
Description of current programs, activities and accomplishments.
Organizational chart, including board, staff and volunteer involvement.

B. ATTACHMENTS

1. Executive Summary

A copy of the current IRS determination letter indicating 501(c)(3) tax-exempt status.
List of Board of Directors with affiliations.
Finances:
1. Organization’s current annual operating budget, including expenses and revenue.
2. Most recent annual financial statement (independently audited, if available; otherwise, attach Form 990).
Annual report, if available.