Request a Grant

September 15, 2023: We are currently experiencing issues with our form below. Please submit application and supporting documents directly to Kent Gernander.

Please review the grant information prior to completing and submitting this form.

Note: an asterisk * denotes a required field.

Grant Submission Form

Project Information

Enter the details of your project below.

Please describe in detail the purpose and overall goals of your project.

Give an estimate of the number of individuals who benefit from your project.

What are the benefits to the individuals, organization and/or community?

Please itemize the projected expenses and then provide the total cost for the project.

List your other expected sources of income (such as other foundations, clubs, individuals, etc.). Please indicate the source(s) and the anticipated amount(s).

List sources and amounts already committed.

Please enter the TOTAL amount you are requesting from our foundation.

List specific expenditures to be made of funds granted by the Foundation.

Contact Information

Enter all individuals who are requesting this grant.

Organization Information

You must submit a copy of your IRS Determination Letter demonstrating tax-exempt status, and a current financial statement of the organization. You may upload those documents below, or if you are unable to do so, you may mail them to the Foundation.

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Provide the names of your organizations officers and board members.

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