GRANTS

2019 Community Grant Application

Please fill out all applicable fields below. If you wish, you can finish filling out the application at a later date by clicking the “Save and Continue Later” button at the bottom. This will direct you to a page that will instruct you on how to return to the form when you’re ready to continue.

1. AGENCY PROFILE
Organization Name*
Primary Contact*
Position*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Charitable Registration #*
Date of Incorporation*
Date Format: MM slash DD slash YYYY
Website*
# of Full Time Employees*
# of Part Time Employees*
# of Volunteers*
Previous Grants
Please list previous grants received from the Brandon Area Community Foundation.
Date: Purpose: Amount:
Was Final Grants Report filed:
- Yes
- No
2. AGENCY INFORMATION
What is the purpose of the organization?*
What services are provided? (include target population, geographic area served, and number of people served)*
3. GRANT REQUEST
Amount Requested*
Total Cost of Project*
Project Start Date*
Date Format: MM slash DD slash YYYY
Completion Date*
Date Format: MM slash DD slash YYYY
Please provide the project description on a separate document and attach with application*
Accepted file types: pdf.
Sources of Funding
Please identify other sources of funding and dollar amounts for this project.
Name Amount Confirmed? (Y or N)
Partial Funding - Would your organization be able to continue the initiative if you were to receive only partial funding in support of your request?*
- Yes
- No
If yes, please elaborate:
Is your local Community Foundation a Funding Partner?*
- Yes
- No
If yes, please elaborate:
If no, please elaborate:
How will this project be evaluated?
If your project is successful, how will your organization recognize BACF and other funding partners?
6. COMMUNITY REFERENCES
Please provide the name, phone number and contact person of two organizations who may be contacted by the Brandon Area Community Foundation in support of your organization's application for funding.
1. Organization Name*
Contact Person*
Email
Phone*
2. Organization Name*
Contact Person*
Email
Phone*
4. ATTACHEMENTS TO BE INCLUDED:
Please check off all items*
- Most current audited or reviewed financial statement
- Total revenue and expense budget for the current year
- Budget for proposed project
- List of current Board Members and contact information
Files*
Drop files here or

Accepted file types: pdf.
5. AUTHORIZATION
This application must be signed by an officer of the organization's Board of Directors (Chair/President, Vice-Chair/Vice-President, Treasurer, Executive Director or General Manager of the organization). By signing this application the applicant agrees to the grant terms and conditions and gives BACF permission to publish photos, grant recipient stories, and grant information upon approval of the grant. Grant applications, which are not approved, will remain confidential.
Name*
Title First Last
Phone*
Date*
Date Format: MM slash DD slash YYYY
Signature*
Phone
This field is for validation purposes and should be left unchanged.

GRANTS

2019 Community Grant Application

1. AGENCY PROFILE

2. AGENCY INFORMATION

3. GRANT REQUEST

6. COMMUNITY REFERENCES

4. ATTACHEMENTS TO BE INCLUDED:

5. AUTHORIZATION

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Date:	Purpose:	Amount:

Name	Amount	Confirmed? (Y or N)