PROJECT NAME* ORGANIZATION WEBSITE*
ADDRESS* ADDRESS LINE 2 / SUITE*
CITY* STATE* POSTAL / ZIP CODE*
NUMBER OF FULL TIME EMPLOYEES* NUMBER OF PART TIME EMPLOYEES* NUMBER OF VOLUNTEERS*
FIRST NAME* LAST NAME*
TITLE* PHONE NUMBER* EMAIL ADDRESS*
ORGANIZATION MISSION STATEMENT*
PROJECT NAME* YEAR ESTABLISHED* FUNDING AREA*
PHONE NUMBER* EMAIL ADDRESS* 501 (C) (3)?* YESNO
CURRENT ANNUAL BUDGET* REVENUE FROM GRANTS* AMOUNT REQUESTED*
TOTAL PROJECT BUDGET*
BRIEF DESCRIPTION OF ORGANIZATION
POPULATION SERVED
PERCENT OF CURRENT ANNUAL BUDGET GOING TO PROGRAMS PERCENT OF CURRENT ANNUAL BUDGET FROM GRANTS COUNTY BEING SERVED BY THIS PROPOSAL PROJECT START DATE PROJECT END DATE ORGANIZATION DESCRIPTION* (Please provide a description of the organization's current work and how this work aligns with the Foundation’s program areaunder which the proposal is being submitted (Education, etc.).
ISSUES TO BE ADDRESSED* A description of the issue(s) to be addressed by the applicant's proposed project).
ACTIVITIES / STRATEGIES* (A list, in bullet format with narrative text as appropriate, of the speci c work strategies and activities of the organization to address the problems outlined above).
EXPECTED OUTCOME*(A description of the applicant organization's expected outcome for the requested grant period listed in bulleted format with narrative text as appropriate).
ASSESSMENT*(Plans and methods for assessing the occurrence and quality of the organization's outcome and progress toward its goals).
ONGOING FUNDING*(List your plans/sources of ongoing funding to sustain activities/programs to be supported by this grant).
PROJECT BUDGET*(Provide a detailed budget for the project, including the amount and states of other grants requested and/or awarded).
FINANCIAL STATEMENTS* (Please attach your most recent audited financial statements).
UNAUDITED FINANCIAL STATEMENT* (Please attach a copy of the organization's unaudited financial statement for the current fiscal year).
ORGANIZATION’S BUDGET* (Please attach a copy of the organization's budget for the fiscal year).
501c3 DESIGNATION LETTER* (Please attach a copy of your organization's 501c3 designation letter).
