MOBILIZE POWER FUND PROPOSAL COVER SHEET
Date of Application:
Grant Request Amount: $
Grant Request / Project Summary (1-3 sentences):
How did you hear about the Mobilize Power Fund?
Type of Application: Single Organization Partnership / Coalition
Organization Name(s):
Partnership / Coalition Name (if applicable):
Street Address:
City: State: Zip Code:
Telephone Number: Web Site:
Executive Director (if applicable): Email:
Primary Contact Person, Role, & Email (if not ED):
Additional Contact(s), Role(s), & Email(s) (for Partnerships / Coalitions):
Tax Status: 501(c)3 501(c)4 Other: Federal EIN#:
Total organizational budget for fiscal year for which funding is requested:
Best way to contact you within 24-48 hours of the review date:
____ Primary Contact Person Email (listed above)
____ Executive Director Email (listed above)
____ Phone Call (number: _________): mark “S” if you prefer phone calls through Signal
____ Text Message (number _________): mark “S” if you prefer texts through Signal
____ Other Contact Method:
If you have a fiscal sponsor, please complete the following information:
Fiscal Sponsor Organization Name:
Fiscal Sponsor Address:
Fiscal Sponsor Telephone Number:
Fiscal Sponsor Director Name:
Fiscal Sponsor Director Email:
If you are applying for project support, please answer the following questions:
Name of project:
Total project budget for fiscal year for which funding is being requested:
Does the project include any lobbying?
If yes, what type of lobbying and how much will be spent on each type?*
Grassroots –
Direct –
* For more information on lobbying that the types of lobbying nonprofit organizations can engage in, please visit Bolder Advocacy as a resource.