Grant Application - Crawford Heritage Community Foundation

Legal Name of Organization

Mailing Address

Web Site Address

Federal Tax ID Number

This is a nine-digit number of two-digits followed by a dash, then the last seven-digits. Example: 01-2345678

List names of co-applicants if this is a joint proposal.

Type of organization. (Select the category that describes your organization.)

Tax-exempt, nonprofit corporation, as described in United States Internal Revenue Code (26 U.S.C. § 501(c) Governmental body Municipality School Faith-based and/or religious programs (Titusville-area only)A copy of your current IRS determination letter, indicating your tax exempt status, may be requested if we cannot determine it using Guidestar.

Title

E-mail Address

Project Name

One Sentence Description of Grant Request

Please limit your response to no more than 325 characters (approximately 50 words). RESPONSES LONGER THAN 325 CHARACTERS WILL BE SHORTENED BY THE FORM.

Major Funding Category: (select the category that best describes your grant request)

Agricultural, horticultural, environmental protection and/or beautificationArts and culture Benevolent, charitable and/or civic functions Community development Education and/or literary pursuits Health and/or safety Research/scientific development

Certification

I certify that this application has been made with the support of the Governing Board and chief executive of my organization.

Organization Information – Briefly summarize your organization’s history, mission, current programs and activities. Include a brief overview of your organizational structure, including board, staff and volunteer involvement.

Please limit your response to no more than 1400 characters (approximately 200 words).

Purpose of Grant – Describe the proposed program/project identifying the needs/problems to be addressed and how you will incorporate preventive and/or curative approaches to the problem. Identify project goals and objective and your timetable for implementation. Include information about the targeted population and your plans to avoid program duplication. How will the project/program promote cooperation and improve upon the effectiveness of existing organizations?

Please limit to no more than 2100 characters (approximately 300 words).

Evaluation – Describe your plan to document progress and results. How will you tell if the project is successful? Final evaluation and expenditure reports will be required for every grant awarded.

Please limit to no more than 1400 characters (approximately 200 words).

Future Funds – Indicate how the project/program will be funded in future years.

Please limit to one paragraph or no more than 700 characters (approximately 100 words).

Project/Program Budget - Provide a detailed project/program budget that specifically outlines all funds that you are requesting.

Upload your project budget as one of the following types of files: .txt, .doc, .docx, .xls, .xlsx or .pdf. A hard copy may be mailed to the Foundation if one is not uploaded.

Board Composition - Provide a list of your board members and their contact information

Upload your board list as one of the following types of files: .txt, .doc, .docx, .xls, .xlsx or .pdf. A hard copy may be mailed to the Foundation if one is not uploaded.

Estimates - Provide copies of estimates from outside vendors. Disregard this question if no outside estimates were needed.

Upload any estimates as one of the following types of files: .txt, .doc, .docx, .xls, .xlsx or .pdf. A hard copy may be mailed to the Foundation if one is not uploaded.

Audit - Provide a copy of your most recent audited annual financial statement. (Do not provide a copy of your IRS Form 990.)

Upload your most recent audited financial statement as one of the following types of files: .txt, .doc, .docx, .xls, .xlsx or .pdf. A hard copy may be mailed to the Foundation if one is not uploaded.

Grant Application - Crawford Heritage Community Foundation

Narrative

Financial Information

Attachments/Document Upload