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GRANT APPLICATION FORM PACKAGE


Applicants are invited to attach pages to their application form.  Instructions for providing supplemental information are provided in Step 7 on our Info for Grantseekers page.

Have you submitted an LOI in this grant year?
Note: You must complete the LOI Process before applying for a grant. If you answered no here, please stop and refer to Steps 1- 4 on our Info For Grantseekers page.
Have you received an invitation to apply via email from our Executive Director?
Note: Our grant applications are accepted by invitation only. All invitations to apply are sent via personal email from our Executive Director. If you answered no here, please stop and refer to Steps 1-5 on our Info For Grantseekers page.
Are you submitting this application before the March 15th deadline?
Note: Applications received after March 15 will not be considered for funding this calendar year. All late applications will be slated for review the following year and you may be required to complete a new LOI and Grant Application.
Legal Name of Organization:
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Address:
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City, State and Zip:
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Is the organization affiliated with a national organization?
If so, please provide detail:
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Year Established:
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Tax I.D.#:
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Website Address:
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Which Davison Bruce Foundation Funding Priority fits your organization?(check one)
Primary service category of your organization(check one)
Mission Statement:more details
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Briefly describe your organization and its key programs, including target populations and service areas:
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# Full-time staff:
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#Part-time staff:
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#Volunteers
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Executive Director:
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Telephone #
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Person to contact regarding this grant request:
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Telephone #
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Are you a returning grantee?:
Funding Amount Requested:
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Type of request :(choose one):
Is this a multi-year grant request?
If so, provide detail:
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Is the a matching grant request?
If so, provide detail:
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Purpose to be served by grant:
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Provide a brief summary of the proposed project/program or services to be provided:
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State why this project/program or service is needed:
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Provide a brief summary of the anticipated outcomes:
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How will you evaluate whether your project/program or services provided were successful?
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How will your project/program or services provided be sustained after this grant?
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Please provide budget information for the proposed project/program or services to be provided, including budget items, support from other sources and total anticipated cost of the project/program or services:

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What percentage of funding for your project/program or services to be provided are you requesting from the Davison Bruce Foundation?

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What are the approximate annual expenses of your organization?
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What is the value of your endowment fund, if any:
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Do you personally know any members of the Davison Bruce Foundation? If so, please list them here:
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APPLICATION AUTHORIZATION AND CERTIFICATION

 

In submitting this application, the applicant certifies that:

 

  1. The applicant has been recognized by the IRS as an organization described in Section 501(c)(3) of the Internal Revenue Code.

  2. The applicant has not received a revocation or change in their charitable status and to the best of the applicant’s knowledge, there has been no proposed, threat, or suggestion by the Internal Revenue Service that the applicant’s charitable recognition status should be revoked or modified.

  3. None of the requested funds will be used by the applicant to support or oppose legislation, or otherwise engage in grass roots or direct lobbying activities, to conduct any voter registration drive or activities, or to support or oppose any candidate for elective public office.

  4. The applicant does not discriminate in conducting its affairs against any person on account of race, color, national origin, sex, religion, or age.

  5. The applicant’s governing body has authorized the undersigned office to submit this application and certification.

  6. The applicant commits to advise the Davison Bruce Foundation of any change in the certifications contained herein which occur while this grant application is pending.

 

Authorized person completing this form:
Nameyour full name
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Title:
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Dateof appointment
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