The Greater Cedarburg Community Foundation, Inc.

Detailed Grant Application

Submission date ____________________________

Organization name ________________________________________

Address _________________________________________________

City ________________________ State _________ Zip __________

Phone ____________ Fax _____________ E-mail________________

Members of the Organization's governing board ________________________________________________________

_______________________________________________________________________________________________

_______________________________________________________________________________________________

Contact information

Name of contact person _______________________________

Address ____________________________________________

Phone ____________ Fax __________

E-mail ______________________________________________

Amount requested _________________________________________

Total project/program budget ________________________________

Project/program time frame

Start date ______________ Completion date ______________

Dates Foundation funds are required _____________________

Is the organization an affiliate of an "umbrella organization" such as United Way?

Yes ______ No ______

Project/program name _________________________________________

Project/program summary:

 

Describe the community need for this project/program:

 

Are there comparable projects/programs in the community and, if so, how does yours differ?

 

Project/program budget.

For both revenues and expenses, provide a detailed list of sources, descriptions, amounts and appropriate totals.

 

_______________________________________________________________________________

Print name and title

 

______________________________

Signature of applicant