Branch County Community Foundation : Grants & Scholarships : Grants : Online Application

***DO NOT USE THIS FORM TO SUBMIT AN ACTUAL APPLICATION FOR FUNDING.***

Use this form ONLY if you are uncertain your project qualifies for funding.

After we receive your inquiry, we will contact about proceeding to the application process.

Proposal Date:

Organization's Name:

Address:

City, State, ZIP:

Contact Person for questions about the proposal:

Contact Phone:

Email Address:

Best day(s) and time(s) to contact you:

Organization's Website Address:

Project Name:

Describe the project and how you will use grant funding:

Date(s) of Project :

Geographic Area(s) Served:

	Branch County
	Colon
	Branch & Colon

Youth Involvement

Check all that apply:

	the applicant organization has youth on the governing board
	youth serve on the applicant organization's standing committees
	a youth advisory committee was formed to seek input for this project
	youth assisted in the writing of the grant application for this project
	youth input was sought on the project design
	Not Applicable

Amount Requested:

Total Project Cost:

Is your organization contributing any of its own funds?:

	Yes
	No

If not, please explain why not.:

CERTIFICATION OF APPLICANT

By submitting this form, you are certifying that the information on this pre-submission form is true and complete to the best of your knowledge. You are also certifying that you understand that expression of interest or the provision of an application should not be considered a guarantee of funding. All grant requests go through a complete review process before any funding decision is made.

Colored fields indicate required information.