Grant Application Form With Project Type
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4GRANT APPLICATION FORM
ORGANIZATION INFORMATION
Name of Organization:
_________________________________
Project Title:
_________________________________
Project type: (select one)
Civic and social services
Health and fitness education
Art and music therapy programs
Healthcare and medical research
Address:
_________________________________
City/Zip Code:
_________________________________
Organization website:
_________________________________
Contact Name:
_________________________________
Email:
_________________________________
Senior Management
Official
_________________________________
Phone Number:
_________________________________
Tax ID #
_________________________________
Number of staff/ volunteers
______ full time
_______ part time ______ volunteers
Annual operating budget
___________________________
% of income used for administrative costs
________________
% of income from the following sources:
_____ Government funding
_____ Corporate / Foundation grants
_____ United Way
_____ Other workplace campaigns
_____ Individual contributions
_____ other
_____ Special Events
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Parent category: Business