Is your organization a Yes, EIN # No 501(C)3? ________________________ 501(c)3 is not required. How did you hear about this Newspaper CKSNI Steering Member. opportunity? If so, who? _______________ Email Government Official. Facebook If so, who? _______________ Which project area will you Human & Community Development Education target with this project? Community Spaces, Parks, & Housing Recreation Centers Economic Development/ Business How much money are you requesting from this grant? $_________________________ What other resources (e.g. funding, volunteers, donated supplies, donated facilities, etc.) will support this project? APPLICATION FORM Please answer the following questions within this document or attach a letter addressing the questions below. Please provide a brief description of your group/organization and include mission, vision, past accomplishments. Please provide information about your staff or volunteers. Please state the goals of your proposed project. Who will benefit from this benefit from your project and what is your target area? What is your project timeline? Explain how you will use your proposed funding. By signing this application, I am stating that the information provided in this application is correct and I am the authorized representative of the organization or Signature: _________________________________________ Date: ______________________ Printed Name: _____________________________________ Title: _____________________________________________
Is your organization a 501(C)3? 501(c)3 is not required. Yes, EIN # ________________________ No How did you hear about this opportunity? Newspaper Email Facebook CKSNI Steering Member. If so, who? _______________ Government Official. If so, who? _______________ Which project area will you target with this project? Human & Community Development Community Spaces, Parks, & Recreation Centers Education Housing Economic Development/ Business How much money are you requesting from this grant? $_________________________ What other resources (e.g. funding, volunteers, donated supplies, donated facilities, etc.) will support this project? APPLICATION FORM Please answer the following questions within this document or attach a letter addressing the questions below. Please provide a brief description of your group/organization and include mission, vision, past accomplishments. Please provide information about your staff or volunteers. Please state the goals of your proposed project. Who will benefit from this benefit from your project and what is your target area? What is your project timeline? Explain how you will use your proposed funding. By signing this application, I am stating that the information provided in this application is correct and I am the authorized representative of the organization or Signature: _________________________________________ Printed Name: _____________________________________ Title: _____________________________________________ Date: ______________________
cksni-2015-minigrant-final.docx