Form

WRJSL Community Impact Grant Application

Submission Guidelines Checklist; Make sure your application includes the following:

Grant Application Form
Application is acknowledged by the Preparer and CEO or Executive Director
Detailed project budget that ties to your grant request
A copy of the most recent annual budget
Project cost documents including at least 2 quotes/bids

Organization Name

Contact Name

Email Address

Mailing Address (address check will be mailed if money is awarded)

Phone Number

Project Name

Funding Request Amount

Describe the purpose and structure of your organization (i.e. Board of Trustees, etc.):

Do you submit a 990 to the IRS?

If Yes, what type of form?

If No, then please explain:

EIN:

Have you received a grant from WRJSL in the past?

If yes, when:

Describe the specific project for which you are requesting funding and specifically how the money will be used:

Is this a new venture or an expansion of an existing project?

If money is awarded, what is the projects' timeline for implementation?

Briefly describe both the immediate and long-term results anticipated from this project:

Name other organizations, if any, you will work with on this project?

What other funding sources do you have, or plan to approach for this project?

How will this project be funded in the future?

Approximately how many people will benefit from this project?

If WRJSL provided only a portion of your request, what would happen to this project?

If money is awarded, how will you promote that WRJSL was the sponsor (press release, newsletter, etc.)?

Would there be an opportunity for WRJSL members to volunteer or be on the supervising body of your organization?

How did you learn that WRJSL provides grants?

Supporting Documents: Project Budget, 2 Written Quotes for Project. SEE INSTRUCTIONS FOR REQUIRED SUPPORT DOCUMENTS. (If Applicable)

Submitted by:

Date:

Title:

Executive Director or CEO's Name:

By checking here, I affirm that the CEO/Executive Director is/are aware of and support this grant application and that all facts, figures and representations made in this application are true and correct to the best of my knowledge.

I affirm

Cancel