Step 1 of 4 25% Organizational DetailsOrganization Name:*Program Name:*Website URL:*Address:*City:*Zip Code:*Contact Person/Title:*Executive Director:*Grant Amount Requested:*Date Submitted:* Date Format: MM slash DD slash YYYY Year Established:*Tax ID Number:Telephone:*Fax Number:Email* Attachments * Indicates field is required. Allowed files types: (Excel,PDF,Text,Word)Upload Cover Letter on Letterhead Signed by Board Chair**Please provide a brief summary of the program (1,500-word limit). Be specific in describing the program the grant will support and how the grant will be used. Also include the program objectives, term of the program, a definition of desired outcomes and how they will be measured, funding sources after the grant period, and any other pertinent information. Please use a line-item program budget.Program Summary:*Upload Mission Statement*Upload List of Board of Directors*Upload Board Meeting Schedule*Upload IRS Determination Letter*Upload Proposed Program Budget*Upload Qualifications of Key Project Personnel*Upload Audited Financial Statement (Form 990 may be substituted)* Additional Funding Sources List additional funding sources for this program with amounts and special terms. * Indicates field is required.1.$2.$3.$4.$5.$6.$ Submit your application Review your information. If anything is incorrect, go back to update and save. {all_fields}
