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Name*
   
Address*
   
Email Address*
   
Authorized Contact Person*
   
Title*
   
Phone*
   
Purpose of Organization*
   
Year Founded*
   
Total Current
Operating Budget*
   
Primary Source of Funds*
   
Percentage of Federal Funds*
   
Percentage of State Funds*
   
Tax Exempt Under IRS?*   Pending?*  
   
Federal Tax ID#*
   
Proposed Use of Grant*
   
Amount Requested*
   
Total Project Cost*
   
Numbers Served*
   
Geographic Area Served*
   
Project Time Period*
   
Other Sources of Funds
to Support Project*
   
Has this organization applied for, or received a grant from MCF in the past?*  
If Yes, please give details:
 
   
IRS Letter of 501 (C)3*
(2 MB Limit)
   
Narrative Description*
(2 MB Limit)
   
Board Members List*
(2 MB Limit)
   
One-page Project Budget*
(2 MB Limit)
   
Organizational Budget*
(2 MB Limit)
   
Key Staff Members Involved and Qualifications*
(2 MB Limit)
   
By typing my initials and date, I hereby certify that the above information to be correct and that this application has been authorized by the Governing Board.
 
Initials*   Date*
 
 
 
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