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Organization:
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Contact:
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Section 1 - Applicant Information:
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Date Submitted:
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Organization Name:
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Mailing Address:
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City:
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State:
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Zip:
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Phone:
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Email:
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Grant Amount Requested:
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Contact Person:
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Contact Person Title:
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Person Responsible for Project:
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Please list the history of your organization’s grants received from the Wichita Falls Area Community Foundation that includes the following:
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Note: There is a one year time period between grants funded.
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Section 2 — Organizational Overview:
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History and description of your organization (1,000 characters max):
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Primary purpose and programs provided by your organization (1,000 characters max):
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Geographic areas served by your organization (1,000 characters max):
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Section 3 — Nature of Request and Project Description:
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Amount Requested:
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Description of Project (1,000 characters max):
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Needs addressed and principal goal(s) (1,000 characters max):
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Description of target population to be served (1,000 characters max):
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Section 4 — Measures of Success:
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What are the objectives of this project? (1,000 characters max)
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What are the anticipated benefits? (1,000 characters max)
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What is the work plan and timeline for completion? (1,000 characters max)
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Section 5 — Evaluation:
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Describe the evaluation process to be used for this project (1,000 characters max):
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Describe the on-going funding for this project (1,000 characters max):
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Section 6 — Financial Information:
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Total Budget for this Project:
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List the grants received and grants pending for this project (1,000 characters max):
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Organization's Operating Budget for Current Year:
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Section 7 - Last 2 year’s Form 990 information:
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(Your progress will be saved before opening the 990 form)
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Section 8 - The Grant Packet w/supporting documents:
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