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Grants Application

Project Name*

Agency Information

Your Organization*

Provide a brief description of your organization, its staff, services and programs. Be sure to

include the date the organization was founded and its mission.

Geographic Area*

Geographic area served by organization (where possible, identify counties):

Does your agency have a 501(c)3 or other nonprofit designation by the IRS?*

Please select the appropriate response from the list below:

Choices

Yes, we have our own status independently

Yes, we have status due to our affiliation with another organization

Yes, we have status as a church

Yes, we have status as a governmental entity

No, we do not currently have a nonprofit status

Is your organization a government agency?*

Choices

Yes

No

Does the organization have a strategic plan?*

Choices

Yes

No

Has your organization requested funding from ABC before?*

Choices

Yes

No

Has your organization received funding from ABC within the past three years?*

Choices

Yes

No

If you have received funding from ABC, in what amount(s) and for what

purpose?

Project Information

Project Description*

Describe the proposed project and its anticipated impact. Include any relevant data or

supporting statistics and any outcomes that you envision should your request be funded. Please

be specific and avoid generalities.

Amount Requested*

The maximum grant award is $25,000, and the minimum grant award is $5,000.

Collaborations*

What other nonprofit organizations, government agencies, residents, and/or businesses (i.e., all

stakeholders) are working with you on this project?

Other Programs*

Explain the relationship of the proposed project to other programs in the community designed

to meet the same or similar needs or opportunities.

Project Staff*

How many staff will work on this project? What are their qualifications to accomplish the

project goals?

Time Frame*

Define the time frame of the project and the approximate date the project will be completed.

Evaluations: Baseline Data and Indicators*

Briefly describe the baseline data that is relevant to your project and the indicators you plan to

track.

Evaluation: Expected Changes*

Briefly describe the short-term and intermediate-term changes you expect to result from this

project, and how you will measure those changes. Frame your long-term evaluation to address

these 3 broad questions: (1) How much did we do? (2) How well did we do it? and (3) What

difference did we make?

Proposed Project Budget*

What is the budget for the specific project that ABC funding will support?

Outline all expenses and revenues needed to complete the project described in this application.

You may attach a pdf file of your budget or input the information in the space below.

NOTE: Do not include your organization’s overall operating budget here.

Other Support*

Please list any other key sources of funding for this project, and indicate whether each is

committed or pending. Be sure to indicate any other sources of funding that will require

matching support.

Future Funding*

What are the plans for continuation of this project, including future funding sources?

Attachments

IRS Letter of Determination

Optional Document Attachment

If you would like to provide a supporting document relating to your project, you may upload a

pdf version here.


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