Fields marked with an asterisk (*) are required.

    CONTACT INFO

    Applicant must be a not-for-profit 501(c)3, a school or other unit of government. Funding available up to $10,000.

    Can project be partially funded?*

    PROJECT DETAILS

    PROJECT BUDGET:

    *If project can be partially funded, please fill out the appropriate column and explain above under Explanation of Partial Funding

    Operating Cost Description: (Exclude personnel & overhead expenses of any type

    Full Funding Request

    Partial Funding Request

    Do you need additional space to detail out Operating Costs?


    FULL FUNDING REQUEST TOTAL

    PARTIAL FUNDING REQUEST TOTAL

    SIGNATURE:

    No more than one application may be submitted per non-profit, school, or unit of government.

    • Applications from non-profits must include the signatures of the Executive Director/CEO and the Board Chair/President.

    • Applications from schools must be signed by the Teacher and Principal.

    • Applications from other units of government must be signed by the organization’s top Administrator or Board Chair.

    Signature 1*: Please sign in the grey area below and add your name & title




    Signature 2: