missions grant funding

Grant Funding Application

All information provided below will be kept confidential.

ORGANIZATION INFORMATION

* Indicates required field

Name of Organization applying: *

Physical location or organization: *

Mailing Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone number for organization: *

Executive Director/CEO/President: *

Website: *

Annual Budget of the organization: *

Total number of full/part time staff: *

Number of Years in Operation: *

Organizational Mission: *

Area of Service: *

Does the organization have a Strategic plan: *

Are you part of any national/regional/etc. Organization? If yes, please provide name of Organization: *

Do you currently partner with other organizations and if so please list: *

Are you affiliated with any Christian organization or is any part of your program placed in Christian principles and if so please elaborate: *

PROGRAM INFORMATION:

Name of program(s) seeking funding: *

Program director: *

Target population of program: (infants/toddlers, school age children, elderly,etc.) *

Briefly describe the programming provided: *

What are the anticipated outcomes of the program: *

Number of individuals (unduplicated ) served in past year: *

Number of units of service provided in the past year: *

Please share any success stories: *

Specifically, how will grant funds received be used: *

Has the program been funded by other sources in the past and if so please elaborate: *

Please provide annual budget of program. Are matching funds available or being used?: *

ADDITIONAL INFORMATION NEEDED

Please email a copy of the following to [email protected]

1. A copy of your IRS 501(c)(3) determination letter
2. A roster of your board of directors
3. Meeting schedule of board of directors
4. A copy of your current profit and loss statement
5. A copy of your current budget
6. A copy of your most current IRS Form 990

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