Use this form to apply for a donation of more than $1,000. For smaller requests use our ‘Application for a Donation of $1000 or less’ form,available at:

Please make sure you review the instructions and the application form carefully. Due to the volume o f requests, incomplete and improperly submitted applications will not be reviewed.

The Narrative section of the proposal should be as short and succinct as possible (absolutely no more than five pages, less is more). Please type in the answer boxes for each question. (Make sure your “View” for this document is “Print Layout”.) Please also attach verification of your nonprofit status (e.g., 501(C)3 letter).

We review requests of $1,000 or more monthly and all requests must be received at least eight weeks before a decision is needed (e.g., if you are asking for a donation for an event on June 1st and the deadline for including sponsors in the event materials is May 5th, your request would need to arrive no later than March 10th, 8 weeks before May 5th). We respond to all requests via an award or decline letter within 8 weeks.

We can only award one grant per calendar year to an organization. So please try to include all opportunities for our investment for this year in one proposal.

Check carefully to make sure you are pleased with all your answers and then submit your FULLY COMPLETED application (Cover letter on your letterhead, Cover Sheet, Narrative and Verification of nonprofit status) by mail to:

For organizations in Massachusetts, New Hampshire, Rhode Island, and Connecticut (except New Haven and Fairfield counties)

Community Affairs

Stop & Shop Supermarket New England Division

1385 Hancock St

Quincy, MA02169

For Organizations in New Jersey, New York, and Connecticut (New Haven and Fairfield counties only)

Community Affairs

Stop & Shop Supermarket New York Metro Division

1160 Kings Highway. Cutoff

Fairfield, CT06824- 5271

Organization
Lead Contact + Title
Phone
Email
Web
Mailing Address
(Street/City/State/Zip)
Project(s) to be Funded
(less than 75 words)
Amount of Grant Requested
Number of People Served
Communities Benefited (Geographic)
List Stop & Shop Stores (names and distances) Within 10 Miles of your Location (if none, where are the closest stores) / Store(s) Distance
e.g. Bridgeport CT, 4531 Main St 2.2 miles
Have we Funded Your Organization in the Past? (if ‘yes’, please detail)
501(c)3 Tax ID Number (we also need a copy of the letter)
If Donation is for an Event, What is the Date of the Event?
What is Your Deadline for a Decision? Do you Have Other Deadlines (e.g., deadline for inclusion in program book)?


  1. How does this request address one (or more) of our corporate giving priority areas? (Detail below and check all that apply)
  1. Healthy Living (Nutrition, Exercise and Play)
  2. Hunger Relief
  3. Kids
(If this request doesn’t address one of our priority areas please explain any fit or connection that you think is important for us to be aware of)
  1. What is your organizations total annual budget? What is the overall budget of the project you are seeking funding for?

  1. What are you planning on using the requested funds for?

  1. What do you hopeto achieve with our funding? (e.g., # of people served, # of hours, etc.) For significant investments, what impacts do you hope to achieve? (Impacts include change in performance, change in behavior, change in results, etc.,)

  1. Who will the funding benefit? (Please provide demographic information on the people/communities that will be impacted.)

  1. Please list all of your board key committee members, including affiliations and titles.

  1. What opportunities do you see for returning value to Stop & Shop via a partnership? (e.g., visibility opportunities, public relations opportunities, etc.)

Please make sure you review the instructions and the application form carefully. Due to the volume of requests, incomplete and improperly submitted applications will not be reviewed.

Completed Application Checklist (make sure all of the following are included)

  1. Cover Letter on Nonprofit Letterhead
  2. Cover Sheet (fully completed)
  3. Narrative (fully completed)
  4. Copy of Letter Verifying Nonprofit Status
  5. Make sure you’re deadline for a response is at least 8 weeks from now

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