OF THE DAYTON FOUNDATION
GRANT APPLICATION
Section one
Date of Application
organization information
Applicant Organization (Full Legal Name)
Organization Mailing Address
Organization City
Organization State
Organization Zip Code
Organization Website
IRS letter date
Tax Exempt ID # (EIN)
Name of Executive Director
Name of Fiscal Sponsor (if applicable)
Grant Proposal Contact Name
Title
Phone
Fax
****IN EFFORT TO CONSERVE PAPER, WE WILL BE SENDING NEXT YEAR’S APPLICATION VIA EMAIL. PLEASE INCLUDE YOUR PREFERRED EMAIL ADDRESS.****
Street Address
City
State
Zip Code
/ THE GREATER DAYTON CONSERVATION FUND
OF THE DAYTON FOUNDATION
GRANT APPLICATION
ORGANIZATION FINANCIAL INFORMATION
Amount / Fiscal Year End (mm/dd/yy)
Most recently completed year-end revenue / $
Most recently completed year-end expenditures / $
Organization’s Budgeted Expenses for Current Year / $
Endowment Size (market value as of fiscal year end) / $
Organization’s Major Funding Sources by percentage (e.g., United Way, local community foundation, etc.)
organization’s affiliation
United Way / Chapter of national region organization / Other
Specify:
request data
Program/Project Title
Total Budget for this Program/Project / $
Amount of this request / $
Grant Duration (e.g., one-year, two year, etc.)
Anticipated Project Start Date
Community/Counties served by this Program/Project
Total Number of people to be served during grant period
Brief demographic description of population served by this Program/Project
Signatures (both are required unless otherwise specified by funder)
Signature of Executive Director
Signature of Board of President
/ THE GREATER DAYTON CONSERVATION FUND
OF THE DAYTON FOUNDATION
GRANT APPLICATION
Please use additional pages for answering the following questions. Your responses should not exceed three pages and should be typed, single spaced, single-sided, and use a 12-point type.
Section two – Project Description
1. Describe project for which you are submitting this grant request.
2. How does this request support the Greater Dayton Conservation Fund’s purpose?
3. What other sources of funds will you explore or do you expect to receive to support this request?
4. When will the funds be required?______
Section Three – Organizational Background
1. Give a brief summary of organization’s history and current program/projects and
activities.
Mail three copies of completed Grant Request Form and documentation of tax-exempt status to: Janice McLefresh, Grants and Programs, 40 N. Main Street, Suite 500, Dayton, OH 45423
Applications must be postmarked on or before the deadline date of
July 15, 2015