Grant Application Contact InformationOrganization NameEINMailing AddressExecutive Director or PresidentContact NameContact TitleContact Email Address Contact Phone NumberOrganization BackgroundDate Founded Number of Full-Time StaffNumber of Part-Time StaffNumber of VolunteersAnnual Operating BudgetOrganization MissionOverview of the Organization's History and ProgramsGrant Proposal InformationAmount of RequestDescribe the project for which you are requesting funding and how those funds would be usedOutline the specific costs of the projectGeographic Area ServedClient Demographic ServedImplementation TimelineHow will results be measuredList all sources from which you have requested funding for this project?Have you received any funding for this project? If so, from whom?AttachmentsPlease attach the following Documentation: Audited financial statements for the last fiscal year, or Form 960Project budgetItemization of use of requested fundsA copy of your 501(c)(3) IRS Determination LetterCommentsThis field is for validation purposes and should be left unchanged.