Fanwood Community Foundation
Application Form
Cover Sheet
(Please feel free to make copies of this form or generate this one-page cover
sheet on your computer.)
Name of organization to which grant would be paid.
Please list exact legal name:
________________________________________________________________
Purpose of grant (one sentence):_____________________________________________________________
Address of
organization:___________________________________________________________________
Telephone number:__________________________________
Fax:_________________________________
E-mail:
_______________________________________________________________________________
Executive director:
_______________________________________________________________________
Contact person and title (if not executive director):
_______________________________________________
Is your organization an IRS 501(c)(3) not-for-profit? (yes or no):
____________________________________
If no, please explain:
______________________________________________________________________
Grant request: $ _______________
Check one:
General support ____
Project support ____
Total organizational budget (for current year): $________________________
Dates covered by this budget (mo/day/year): __________________________
Total project budget (if requesting project support): $ ___________________
Dates covered by project budget (mo/day/year): _______________________
Project name (if applicable): ______________________________________