Grant Application Grant Application Name of Organization * Contact Person and Title * Address Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Email * Phone * Type of Organization * Non-Profit 501(c)3* Civic Religious Government Education OtherOther * If your organization is chosen, you will be required to show proof of non-profit status. Amount Requested * Total Cost of Project * Project Description * Describe the project for which the application is being made. Include specifically what the funds will be used for, what you plan to achieve and how you will measure the success of the project. Project Timeline Start Date Estimated Completion Date What other fundraising have you done for this project? * Are you willing to speak to our group about your project? * Yes No **Failure to present to our group may lessen your chances of receiving your requested funds. Submit If you are human, leave this field blank. For now, please contact us for information.