Grant Application for UNDER $2500

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Cover Sheet
Attachments

Cover Sheet

Please complete the fields on each page. Note that some fields (*) are required before moving to the next page. You may save at any time by clicking the save icon at the bottom right of the form. If you are not able to complete the entire form, you can come back later and finish. Please do not clear your browser cache or delete your cookies until the application is completed.

Name of Organization*

Name

Address of Organization*

Address line one

Address line two

State

Postal Code

Organization’s Federal Tax Identification Number

If Applicable

ID Number

Contact Person's First Name*

First Name

Contact Person's Last Name*

Last Name

Contact Person's Email*

Phone Number*

Phone

Fax Number

Fax

Web Address

URL

Project Title*

Title

Total Project Budget*

Amount

Total Funding Request*

Amount

Grant Period Start Date*

Date ×

Grant Period End Date*

Date ×

Dates of Prior JPMF Grants Received

If Applicable

Dates

Amounts of Prior JPMF Grants Received

If Applicable

Amounts

Executive Summary of Project*

Describe how you will utilize the grant funds to further JPMF’s mission. Explain the problem, need or issue for which the grant is requested, and an estimate of the number of those who will benefit. Discuss how this request will enable your organization to improve its ability to meet program or organizational goals.

Summary

Attachments

Document 1

IRS Exemption (If Applicable)

A copy of the applicant’s current IRS tax-exempt determination letter, unless applicant is a local government agency. If tax-exempt status is pending, provide an explanation of application status. You must receive your 501(c) (3) determination prior to the beginning of the grant program.

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Document 2

990 Form (If Applicable)

A copy of the applicant’s most recent 990 forms.

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Document 3

Other Organizations (If Applicable)

If other organizations will participate in the proposed activities, please provide the name(s) of the organization(s), and a letter from the organization describing their role and the specific activities in the operational plan they have agreed to implement and any resources they intend to provide.

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Max file size: 9.54 MB. | Allowed file types: pdf,rtf,doc,docx,jpg,jpeg,png,csv,xlsx,xls

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Document 4

NOTICE

Please review all of your information before clicking the submit button below.
You are free to go back to previous pages if necessary.
Once you click submit, you will not be able to change any information.

Once your application is submitted you will receive a confirmation email that includes a copy of your application.

You will also be able to Print your application after you submit it.

The Joey Pizzano Memorial Fund

special kids • special families

Cover Sheet

Attachments

Document 1

IRS Exemption (If Applicable)

Document 2

990 Form (If Applicable)

Document 3

Other Organizations (If Applicable)

Document 4

Other Documents (If Applicable)

NOTICE

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