Letter Of Inquiry Template
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1
2
3LETTER OF INQUIRY
Organizations must submit the LOI via U.S. Mail or commercial carrier. It must be postmarked by the day of the deadline.
Please review the How to Apply section under the Grants Program tab on our website for NEW changes.
GENERAL INFORMATION
1. Date: ____________________ Tax ID Number: _________________ Year Founded: ____
2. Organization Name:
3. Phone Number:
Website:
4. Mailing Address:
5. City:
Zip:
6. Contact Name:
Title:
7. Email:
Phone Number:
Ext:
8. Population Served: Developmentally Disabled
Abused or Neglected Youth
Elderly
9. Total Number of Staff:
Full-time:
Part-time:
10. Grant Amount Requested: $
11. Type of Request:
Capital Expenditure
General Operating Support
Program
12. Name of Program (if applicable):
13. Total Number Served (unduplicated):
Agency:
Program:
14. Total Annual Organizational Budget: $
Total Program/Capital Budget: $
15. Principal Sources of Income:
Fundraising:
Foundations/Corporations:
%
Interest:
%
Individual Donors:
%
Participant Fees:
%
Fundraising Events:
%
Private Sector Contracts/Sales:
%
Government Sources:
%
Other:
%
16. Financial Data from IRS 990 Tax Return (for most recent year): 20
Total Revenue: $
Total Expenses: $
Net Assets/Fund Bal: $
Total Liabilities: $
Investments/Securities: $
Total Cash: $
Do you have an endowment? No
Yes
Endowment Balance: $
Permanently restricted?
No
Yes
If YES: By board?
By donor?
PDF.Revised 7/22/2014
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Parent category: Letters