MAGIC PEBBLE FOUNDATION

COMPREHENSIVE APPLICATION FOR RETURNING GRANTEES

INSTRUCTIONS:

  • Use this application for returning grantees requesting more than $5,000.
  • Please keep all answers toless than 200 words (or 2 paragraphs) when possible.
  • If there is important information we should know that is not captured through this application, please let us know.
  • Please fill out this application on your computer, save it, and email as an attachment to

CONTACT INFORMATION

Today’s Date:

Organization Name:

Mailing Address:

City:

State:

Zip:

Website:

Year organization established:

Executive Director:

Email:

Phone:

Contact Person (if different):

Title:

Email:

Phone:

GRANTHISTORY *

*Please note that this section replaces the Status Report previously required. You may fill out either the Status Report OR this section.

  1. Date of last grant received from the Magic Pebble Foundation:
  2. Amount of Grant:
  3. Grant was for: General or Greatest Need Specific Project or Program

If specific program, include program name:

  1. What was the impact of the last grant on your organization and/or program outcomes?
  2. What challenges did you face and what (if any) changes will you make this year?

ORGANIZATION BACKGROUND

Please describe any changes to the following areas since last year (write N/A for no changes):

  1. Your organization’s 501c(3) status.
  2. Number of staff.
  3. Organization’s mission or purpose.

PROGRAMS

Please describe any changes to the following areas since last year (write N/A for no changes):

  1. Key programs.
  2. Geographic area(s) served.
  3. Population(s) served.
  4. Number of people served.

NEED AND ACCESSIBILITY

Please describe any changes to the following areas since last year (write N/A for no changes):

  1. Need for your services.
  2. Who receives your services.

EVALUATION AND COLLABORATION

Please describe any changes to the following areas since last year (write N/A for no changes):

  1. Organization’s goals.
  2. Program evaluation.
  3. Collaborative partners.

BUDGET

  1. Organization’s total revenue from last fiscal year: $
  2. Sources of revenue: Government% Corporations% Foundations%

Individuals% Events% Fees%

  1. Organization’s total operating expenses for last fiscal year: $
  2. Percent of funds spent on: Programs% Administration % Fundraising %
  3. Organization’s total net assets at the end of last fiscal year: $

PROPOSAL

  1. Amount requested: $
  2. Purpose of funds? General or Greatest Need Specific Project or Program
  • If you selected ‘Specific Project or Program’ please note if it is the same program as last year, OR,explain the project or program:
  1. Date funds needed by:

Are there any other updates or things we should know about your organization?

ATTACHMENTS

No attachments are required or expected. However, you can attach documents if they would help us better understand your organization or programs.

1

Magic Pebble Foundation – Return Application for Funds