Submit a Grant Proposal

Organization Name *

Tax ID *

Tax ID

Address Line 1 *

Address Line 1

Address Line 2

City

State

Zip Code

Lead Staff / Contact Person Name *

Lead Staff / Contact Person Phone *

Lead Staff / Contact Person Email *

Email

Confirm Email

Mission Statement of Organization *

Project Name *

Project Overview *

Geographic Area(s) to be Served *

Who Benefits from Project? *

Who Benefits from the Project?

Funding Amount Requested? *

Project Date - Start *

Project Date - End *

Additional Funding Sources? *

Objective/Purpose: What specific community need is to be addressed? How will the objective be accomplished? *

Approach: How and where will the program be implemented? *

Collaboration: Will other programs be Involved with the project? If so, please list. *

Evaluation: How does your organization plan to evaluate the success of the program? *

Foundation Grant Funds: How will Foundation funds be used? *