SACF Community Grant Application – Sussex Area Community Foundation

Organizational Name

Mailing Address

Executive Director / Manager

First

Last

Phone Number (XXX-XXX-XXXX)

Email

Contact Person

First

Last

Phone Number (XXX-XXX-XXXX)

Email

Charitable Registration Number – if you are not a registered charity fill out and attach a ‘Written Agreement with a Charitable Organization” form.

Name of Project

Is this a New or Existing Project

New

Existing

Start Date of Project

End Date of Project

Date Funds are Required for the Project

Is this grant contingent on receiving this grant?

Amount Request from SACF for the Project

How Many Hired Staff do you Have?

How Many Volunteers?

Briefly Describe the Project

Describe the Need the Project is Designed to Meet

How many people will be directly affected from the Project?

How Will the Project be Measured and Reported?

Do you Intend to cooperate with other agencies or non-profit organizations on this project (list organizations)?

What specific items would be covered by a grant from the Sussex Area Community Foundation?

Is additional funding required for this project? If yes please explain how the requirement will be met.

Would this project go ahead if this grant is not awarded?

Yes

No

Please list the ways you will recognize the Community Foundation grant if received.

Budget of Project. (Showing all project revenue and expenses)

Maximum file size: 67.11MB

Latest fiscal year financial statements of your organization (including income statement and balance sheet).

Maximum file size: 67.11MB

Confirmation of Written Agreement Form (if not a registered charity)

Maximum file size: 67.11MB

Questions or feedback regarding the grant application can be forwarded to the Sussex Area Community Foundation office at sacfi@nb.aibn.com or (506)433-6244.

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