Step 1 of 3 33% Organizational Details* Indicates field is required.Organization Name:*Program Name:*Website URL:*Address:*City*Zip Code:*Telephone:*Fax Number:Contact Person/Title:*Email* Executive Director:*Grant Amount Requested:*Year Established:*Tax ID Number: Program Description* Indicates field is required.The Board of Directors is informed of and supports this application.*YesNoProvide a description of the organization's history and background. (100 word limit)*Provide a description of the purpose of the grant. (50 word limit)*Describe the target population to be served by this grant/program. (50 word limit)*Describe the specifics of the program to be funded, identifying key personnel, budget explanation, measurable outcomes/goals. (500 word limit)*Please describe how the organization will fund the program at the end of this grant. (100 word limit)*Supporting Application Documents* Indicates field is required. Allowed files types: (Excel,PDF,Text,Word)Cover Letter from the Chair of the Board of Directors*Mission Statement*Proposed Program Budget*Organizational Budget*Audited Financial Statement (Form 990 may be substituted)*Organizational Chart*List of Board of Directors & Meeting Dates (one document)*Key Personnel Descriptions*IRS Exemption Letter*Other Information Submit your application Review your information. If anything is incorrect, go back to update and save. {all_fields}