Responses will be issued via email within approximately 60 days of submission.
Organizations may apply once per 12 month period.
Committee will consider your past and present application frequency, data, performance, requests, etc.

Please fill out the form below to request a donation!

NAME OF THE ORGANIZATION

CITY, STATE, ZIP

PHONE

TAX ID NUMBER

STREET ADDRESS

NAME OF CONTACT

WEB ADDRESS

PROPOSAL INFORMATION

What are the main goals of the organization/non-profit?*

How will the funding be used?

Dollar amount requested?

What specific impacts does your organization expect to achieve with this funding?*

What are your primary funding sources?

WHAT ARE THE TOP THREE ACCOMPLISHMENTS OF YOUR ORGANIZATION IN THE PAST YEAR:

Accomplishment 1-

Accomplishment 2-

Accomplishment 3-

Charity Navigator Rating

Percentage of Budget Required for Staff Compensation/Benefits for All Staff

Percentage of Budget Going Towards Programs/Causes

Please attach latest 990 form.

Upload File

Please attach most recent 3rd party independently prepared financial statement.

Upload File

Please attach BBB Charity Accreditation certificate.

Upload File

Please attach list of current Officers, Directors, and Key Staff with Bio's

Upload File

Matrix of Support Base

Upload File

Thank you for helping us make a difference!