PhilanthropyNorthwest
CommonGrantApplicationForm
COMMONGRANTAPPLICATIONFORM
Information for Grantseekers
TheCommonGrantApplicationFormwasdevelopedbyacommitteeofPhilanthropyNorthwest in 1998tofacilitatetheapplicationprocessforgrantmakersandgrantseekersin the Northwest.Today, the Common Grant Application is mainly used as a reference and as a tool to prepare for grantwriting. Before you submit a Common Grant Application to a foundation, be sure to check with them to see if they accept the Common Grant Application, and if so, whether they require any additional supporting materials.
•Applications often must be accompanied by a cover letter (no more than one page) in which you state your request and proposed use of funds. This letter should generally be signed by your executive director and your board president.
•Fill out the application form completely.
APPLICATIONMADETO:DATE:
(NAMEOFFUNDINGSOURCE)
APPLICANTORGANIZATION
NAME:Yearorganizationincorporated:
ADDRESS:(includedstreetaddressifdifferent)Isthenameatleftthesameas
itappearsontheIRSLetterof
Determination?YesNo
Ifnot,explain:
CHIEFEXECUTIVE’SNAMETITLE:
CONTACT’SNAMETITLE(ifdifferent):
TELEPHONENUMBER: FAXNUMBER:
ORGANIZATIONALDEMOGRAPHICS:
Numberoffulltimestaff:
Numberofparttimestaff:
Numberofvolunteers:
GEOGRAPHICAREA:
OPERATINGBUDGETTOTALFORCURRENTFISCALYEAR:
FiscalYear:
FromTo
SOURCESOFINCOME:
GovernmentFederal%Fees/EarnedIncome %
State %IndividualContributions %
County %UnitedWay %
City %WorkplaceCampaigns %
(notUnitedWay)
Corporateand/orFoundationGrants %
SpecialEvents %
Memberships %
Other %
PROPOSAL
AMOUNTOFTHISREQUEST:$ FUNDSNEEDEDBY:
TIMEFRAMEINWHICHFUNDSWILLBEUSED:
FromTo
Checkoneofthefollowing:
GENERALOPERATINGSUPPORTPROJECTSUPPORT
Ifforprojectsupport,completethefollowing:
PROJECTNAME:
TOTALPROJECTCOST:$ PERCENTTHISREQUESTOFPROJECTTOTAL: %
PROJECTCOSTPERCLIENT(ifapplicable):$
PROJECTTYPE:
Capital:
construction
renovation
equipment
Endowment
SpecificProgram
Other(describe)
1.WHOWILLPROJECTSERVE:
2.HOWMANYWILLPROJECTSERVE:
- WHATGEOGRAPHICAREAWILLPROJECTSERVE:
FUNDERSREQUESTTHATYOULIMITTHELENGTHOFYOURANSWERSFORTHEFOLLOW-INGQUESTIONSTONOMORETHANATOTALOFFOURPAGES.
1.APPLICANTORGANIZATIONALBACKGROUND
Includeorganizationalmissionstatementandpurpose,organizationalqualifications,historyofaccomplishments,governance,areaandpopulationserved,roleorvolunteers.(Ifthisisacollaboration,describetheleadagencyanditsrelationtoothersinvolved.)
2.NEEDSSTATEMENT
Identifytheneedsyouragencyorthisproposalwilladdress.Acknowledgesimilarexistingprojectsoragencies,ifany,andexplainhowyouragencyorproposaldiffers,andwhateffortwillbemadetoworkcooperatively.
3.PROPOSAL
A.Howwillyourproposaladdressidentifiedneeds?
B.Projectedgoals,objectives,timeline,anticipatedimpact.
C.Expectedroleofvolunteers.*
D.Numberandtypesofpeoplewhowillbenefitfromyourproposal.
E.Howwillyoumonitoryourworkandhowwillyoumeasuresuccessoreffectiveness?
F.Whatareyourotherpotentialandactualsourcesofsupportforthisproposal?
Wheredoyouexpecttofindfuturesupport?
4.APPROPRIATENESSTOFUNDER’SMISSION
Explainhowyourprojectorprogrammeetsthisparticularfunder’sguidelinesandcriteria.
5.ADDITIONALINFORMATION
Pleaseaddresshereanythingelseaboutyourorganizationorprojectyouthinkisrelevanttothisproposal.
*Ifpertinenttothisapplication,howmanyofthepotentialfunder’semployeesarevolunteersinyouorganization?
ATTACHMENTS
InadditiontothecoverletterantheinformationrequiredontheCommonGrantApplicationForm,pleaseattachthefollowing:
1.Verificationoftax-exemptstatusunderSection501(c)(3)oftheIRScode.
2.Listofcurrentboardmembers(includememberaffiliationsandanyotherpertinentinformation).
3.Listofkeyorganizationalstaff,includingtitlesandmainfunctions.
4.IRSForm990(ifavailable).
5.Mostrecentauditedfinancialstatement(ifavailable).
6.Aone-pagesummaryofactualincomeandexpensesforthepasttwocompleteyears;aone-pagelistingoffundingsourcesandamountsreceivedfromthesesourcesoverthepasttwoyears.
7.Organization’scurrentyearoperatingbudget.
8.Adetailedbudgetoftheprojectforwhichfundsarebeingsought(ifapplicable).
9.Iftheprojectforwhichyouareseekingfundsis a collaboration withotheragencies,includelettersorotherdocumentationfromthecollaboratingagencies.