Unrestricted Grant Application

Due November 15th

Applicant Information

Organization:

Contact:

Address:

City, State, Zip:

Phone:

Email:

Grant/Project Information

Title/Name of Program for which you are applying for a grant: *

Is this a new program?:

If no, how has this program been funded in the past?:

Does this project address a specific goal or strategy of the Strategic Community Impact Plan?:

If yes, please identify and explain.:

Projected Dates for Program:

End Date:

Target population (demographic and number):

Brief narrative:

Provide a brief narrative outlining this project and the expected outcome. Include any collaborative efforts with other organizations. Discuss qualifications of your organization to complete such a task.

Budget Information

Total cost of proposed program: $

Grant amount requested from CFWC: $

Explain how these funds will be used:

Other sources of tentative funding:

Attachments

Please attach the following documentation:

Current 990:

501 (c) (3):

Current year operating budget:

List of current board of directors:

5. Profiles of key staff members:

Please be advised that further information may be requested by the Grants Allocation Committee. By submitting this grant application, you agree to abide by the Unrestricted Grants Program of the Community Foundation of Washington County MD, Inc., including any follow-up and evaluation documentation, budgetary requests and publicity.

Community Foundation of Washington County - Looking forward ... giving back

Unrestricted Grant Application

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