Grant Application Form

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Name of Organization: Required

Email: Required

Amount Requested: Required

Demographics

Address 1

Address 2

City

Country

State/Province

Postal Code

Name of Contact Person: Required

Title of Contact Person:

Phone Number Required

A brief description of your Organization: Required

A description of the program or project for which this grant is requested: Required

A description of who or what will benefit from your program or project: Required

Other sources of funding for your program or project: Required

Your plan for funding this project in the future: Required

Please include a proposed total budget for the project including income and expenses. Required

Have you received a grant or funding from the Wayne County Community Foundation in the past 5 years? Required

Yes

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