Grant Application

Comments

This field is for validation purposes and should be left unchanged.

General Information

Name of Organization*

Federal Tax Identification Number*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Website

Primary Contact*

First Last

Title*

Phone*

Email*

Grant Request

Grant amount requested*

Purpose of Grant*

Operating

Program/Project

Other

What is the purpose?

Describe the Purpose for which the Organization seeks support:*

How will Grant effectiveness be measured?*

Will Grant address one or more of the following Exchange Club funding priorities?*

Child Abuse Prevention

Education

Youth Programs

Americanism

Please check all that apply.

Are matching funds available?*

Yes

Please identify each source*

Requested Attachments

Please include each of the following.

Cover Letter

Max. file size: 245 MB.

Current IRS determination letter indicating tax exempt 501(c)(3) status

Max. file size: 245 MB.

Board of Directors list, including names and affiliations

Max. file size: 245 MB.

Current IRS Form 990

Max. file size: 245 MB.

Authorization

The undersigned certifies that the undersigned is authorized to represent the Organization applying for a Grant, and that the information contained in this Application is accurate. The undersigned agrees that if the Grant is awarded to the Organization: (1) the Grant will be used for the purpose outlined in the Grant Award Letter from the Exchange Club of Newport Harbor, and may not be expended for any other purpose without prior written approval from the Exchange Club of Newport Harbor, (2) the Exchange Club of Newport Harbor has received nothing of material value in exchange for the Grant, and (3) information about the Organization and the Grant may be used by the Exchange Club of Newport Harbor in any published materials.

Signature*

Date*

Title*

CAPTCHA

Does your organization Do Work that Aligns with Our Mission?