Philanthropic Grant Application

Philanthropic Grant Application
(Please submit an original and 10 copies of this page)

Name of Organization: ______

Address, City, State, ZIP: ______

Contact Person, Title:______

Phone Number and Email Address: ______

Location of Project: ______
Organization Type: Civic ___ Cultural ___ Educational ___ Humane ___ Social Services ___ Other ___
Organization Description (Briefly list summary of mission, objectives, recent accomplishments, etc.):

How many people are currently served by your organization? ______

Specific Project Request: ______

Dollar amount of this request (submit 10 copies of bid or supporting documentation): $______
Number of people served/helped by this grant? ______
Project Description (Briefly describe the geographic area and people you will serve. Include relevant timetables as they apply to this specific project):

How did you learn of BCC?

Other relevant information useful for evaluation of this request:

Organization’s Web Site URL:______