Grant Application 2008

 

ORGANIZATION NAME:____________________________________________________________

 

ADDRESS:_______________________________________________________________________

 

TITLE OF PROJECT:_______________________________________________________________

 

DESCRIPTION OF PROJECT:_______________________________________________________

 

________________________________________________________________________________

 

DATES OF PROJECT PERIOD:______________________________________________________

 

AMOUNT OF FUNDS REQUESTED $_________________________________

 

AMOUNT REQUESTED FROM OTHER SOURCES:$_____________________

 

ORGANIZATION DIRECTOR:________________________________________________________

 

PROJECT DIRECTOR:_____________________________________________________________

 

TELEPHONE:___________________FAX:__________________EMAIL:_____________________

 

SIGNATURE (AUTHORIZED OFFICIAL):_______________________________________________

Describe applicable programs elements

on a separate sheet:

     

      1. Statement of need

      2. Project activities

      3. Projected beneficiaries

      4. Project goals

      5. Time schedule

      6. Evaluation

      7. Project budget

 

Please attach one copy of the following

documents to your application:

      Board of Directors

      Recent financial statement and       Current budget

 

SUBMIT BY JUNE 1, 2008

 

 

For Office Use

Date Received:

 

Date Reviewed:

 

Date Approved:

 

Amount:

 

Signature:

 

Date Letter Sent:

 

Amount Sent:

 

Notes:

Evaluation Received: