step 1
Organization name:
Executive Director:
Summary of the project(50 words or less):
Project director:
Address:
Phone number:
Compelling reason for the project: (50 words or less)
$ Amount requested:
Area of interest:
Mission statement:
Service Area:
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step 2
The History of the organization with an overview of current programs and activities.
The description of the challenge to be met by the project
The description of the project, strategies, measurable objectives and Timetable.
Plan for continuing the project once the Foundation’s funding ends.
Plan for evaluating the project.
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step 3
step 4
step 5
Program/Project Name:
Program Expenses
step 6
step 7
Write a description of the term of office and the rotation schedule for the board.
step 8
Complete the Board Resolution form below. Ensure it is signed by the authorized representatives.
BE IT RESOLVED that, Executive Director of is hereby authorized and empowered for and on behalf and in the name of this corporation to enter into the following transaction: Grant/contract with The Perry's Foundation, Inc. up to the requested amount of $ BE IT FURTHER RESOLVED that said officer is further authorized to execute any document as shall, in her sole discretion and judgment, be appropriate and desirable to accomplish the foregoing and containing such terms as she in her sole judgment deems advisable.
I certify that I am duly acting and qualified Secretary of and that:
Date:
Attest:
,President/Chairman of the Board
, Secretary
step 9
Please complete and attach the Agreement to Implement Project/Program form executed by the executive or program director and the board president.
If awarded a grant, we will submit an interim report including an accounting of how we used the grant funds midway through project/program completion. We will submit a final report at the completion of the project/program.
Executive Director/Program Manager
Date
Board President Authorization
step 10
Please review your application thoroughly and print a copy for your records. Please note, The Board Resolution Form and the Agreement to Implement Project/Program if Funded form, must be signed. After you obtain the signatures on these two forms, upload the forms along with the other requested forms on the next page
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step 11
Please attach the following documents to complete the form submissions.
notice stating that the organization is tax-exempt or a copy of the organization’s fiscal agent’s 501(c)(3) with a letter from that organization stating its willingness to serve.
Marketing Collateral: Brochures, promotional postcards, etc.
Resumes: (if any)
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