Grant Application 1Applicant Information2Project Information3Documents4Certification Applicant InformationApplicant Name(Required)Agency or individual nameAddress(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Contact Person(Required) First Last TitleEmail(Required) Phone(Required)Agency Website Tax IDRequired for non-governmental agencies.Have you ever received funding from the Mission City Community Fund in the past?(Required) Yes No When have you received funding from the Mission City Community Fund?(Required) Project InformationProject Title(Required)Project Description(Required)Amount Requested(Required)Total Project Costs(Required)If requesting more than $5,000.00 you must submit a budget below.Project Budget(Required)A budget is required when requesting more than $5000.Max. file size: 10 MB.Detailed Project Description(Required)Provide details of the specific project, including: its scope, number of clients served, start and end dates, number of people involved, whether paid or volunteers, and how effectiveness/success will be measured. Include what specific portions of the project will be funded by this requested grant. Include the history of similar or identical instances of this project.Max. file size: 10 MB.Project Status(Required) New Project Continuing Project DocumentsOrganizational History and Grant Details(Required)History of the organization and details of the grant as it applies to the mission of the organization.Max. file size: 10 MB.Most Recent Financial Statement(Required)Accounting statements for the previous year, using generally accepted accounting principles (GAAP). For larger non-profits it is expected that these would be audited statements.Max. file size: 10 MB.Articles of Incorporation(Required)A copy of the letter from the state government certifying the incorporation of the non-profit organization.Max. file size: 10 MB.501(c) (3) Status(Required)A copy of the letter from the Internal Revenue Service certifying the 501(c)3 status of the organization, including the Tax Identification number.Max. file size: 10 MB.Current Board of Directors(Required)A list of the current Board, including the Officers of the organization.Max. file size: 10 MB.Organizational Chart(Required)Specifies how the non-profit is organized, providing all the individuals' names for all levels of the organization, with a notation as appropriate of the paid and volunteer positions.Max. file size: 10 MB.Brochure/Program Information(Required)These are marketing materials produced to introduce potential clients to the deliverables/services that are available. In addition, if there are marketing materials used to solicit donations from other corporations or individuals, those should be included.Max. file size: 10 MB.Letter(s) of Evidence of Community Support(Required)In essence, letters of recommendation from a satisfied client. These are written by an organization or individual who has received products or services from the organization making this grant request and attesting to its value and effectiveness in making a positive difference in the community it is serving. Multiple letters should be submitted as one document. Max. file size: 10 MB.Most Recent Form 990 (including Schedule A)A copy of the most recently filed Federal tax return.Max. file size: 20 MB. Certification(Required) I/We certify that all information submitted as part of this funding request is true and accurate and that as a non-profit agency we are accountable for fulfilling the goals of the project.Signature(Required)Signatory Name(Required) First Last Signatory Title(Required) Δ