Grant Application

Name of Organization*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Website*

Organization Contact*

First Last

Title/Position*

Email*

Contact Phone*

Organization Founding Date*

MM

DD

YYYY

Total Number of Staff*

Does the organization have a Board of Directors?

If yes, please list the names of your board members or provide a link to a website where this information can be found:

Organization's 501c3 No:*

Organization's Mission*

Please summarize the organization's program and services:*

Provide detail as to the type(s) of program(s), number of programs, goal(s) of the program(s), etc.

Please describe the organization's target population:*

Please list the communities where the organization operates:*

Number of individuals served each year:

II. GRANT PROJECT OR PROGRAM

Proposed Project Name*

Amount Requested*

Target Location*

Target Audience*

Describe the program, project, or event:*

Goals and objectives for the project, program, or event:*

Why is this project needed?*

Please provide metrics for the program, project, or event for which you are seeking funding:*

I.e. How many people the program, project, or event will serve, how many items you plan to distribute, how many additional hours of service the proposal will fund, etc.

What is the timeline for the program, project, or event?*

I.e. start date, length of program, project, or event, etc.

Who will supervise and monitor the program, project, or event?*

Monitoring and evaluation plan for the proposed project, program, or event:*

Additional information about the program, project, or event:

III. ADDITIONAL REQUIREMENTS

Please include the following documentation with your grant proposal:*

Please check the items you will submit by DropBox.com

Grant Budget
Verification of U.S. Charitable Status
Annual Report
List of Board of Directors
Reference and/or Letter of Recommendation

DropBox link to supporting documentation:

IV. GRANT PROPOSAL STATEMENT OF UNDERSTANDING

THE UNDERSIGNED, AS A REPRESENTATION OF THE PROGRAM, PROJECT, OR EVENT, ACKNOWLEDGES THAT ALL REPRESENTATIONS MADE IN THIS PROPOSAL AND IN ALL INCLUDED DOCUMENTS AND CORRESPONDENCE WITH THE 4GIRLS FOUNDATION ARE ACCURATE. THE UNDERSIGNED FURTHER ACKNOWLEDGES AND UNDERSTANDS THAT SUBMISSION OF A GRANT PROPOSAL TO 4GIRLS FOUNDATION SERVERS ONLY AS REQUEST FOR FUNDING, WHICH MAY BE ACCEPTED OR REJECTED AT THE DISCRETION OF 4GIRLS FOUNDATION, INC.

Application Completed By:*

Title*

Date*

MM

DD

YYYY

*

I certify and acknowledge all the above

II. GRANT PROJECT OR PROGRAM

III. ADDITIONAL REQUIREMENTS

IV. GRANT PROPOSAL STATEMENT OF UNDERSTANDING

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