Grant Application – Greater Sun Lakes Community Foundation

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Legal name of organization:*

Organization Designated leader:*

Mailing Address:*

Street Address City State ZIP Code

Organization's e-mail address:

Telephone:*

Fax:

Website

What are the organization's mission/values that this grant will address to the targeted population?*

Has the organization been designated 501 (c) 3?*

Please answer YES or NO by clicking in the box.

Organization's taxpayer ID number:

Does your organization have a checking account?*

Please answer YES or NO by clicking in the box

Annual budget of organization:*

for fiscal year*

Total number organization members:*

Brief description of organization and population your organization serves:*

Program/Project Name:*

Amount requested: $*

Time period for program/project: From*

To:*

Under which key area(s) of The Foundation's mission does your program fall?*

Please add Health, Education or Culture by clicking in the box.

Has your organization applied for a grant with our Foundation before? If so, when and how much?*

What will the REQUESTED FUNDS BE USED FOR / the needs the program will fulfill and how many individuals will be served?*

Please be specific with the dollar amounts of each item needed.

Who will benefit directly and indirectly from this program?*

How will you measure the outcomes of the project?*

Authorized e-signature & title*

Date

Telephone:*

E-mail:

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