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2024 Mini-Grant Application

Organization Information

EIN of Organization

Legal Name of Organization

MUST match the IRS Determination Letter and IRS Form 990.

Are your organization's income and expenses less than $300,000?

YesNo

Does your organization have a "reserve" account of some type - CD, savings account, etc?

If the above answer is Yes, what is the total amount in these accounts? If you do not have any type of reserve account, please put 0 in the line below.

Organization Street Address

City

State

Zip Code

Contact Information

First and Last Name

Phone

What is your position within this organization?

Project Information

Explain the program or project you'd like us to fund. Please include when you expect to start and finish the project and the critical nature of the project.

Why has this project not been included in YOUR annual operating budget?

Amount of Funding Requested

Today's Date

Signature

There are 2 required attachments: Organizations are required to attach ONLY pages 1 and 2 of their most recent IRS Form 990 (or their entire Form 990-N). Churches must attach their IRS Letter of Determination instead of a 990.

You must also attach your most recent Annual Operating Budget, which must match the numbers you included above for income and expenses.

BOTH ITEMS MUST BE SCANNED TOGETHER AND ATTACHED AS ONE DOCUMENT.

pdf file only - Attachments other than those requested will not be accepted.

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Contact Information