Community Foundation Grant Application

To apply for the Community Foundation Grant serving the Prophetstown, IL area, please fill out the form below.

Name of Organization

Tax ID Number

Mailing Address

City

State

Zip

Contact Person

Contact Person’s Title

Phone

Fax

Amount Requested

Organization’s Information

Please outline the general purpose of your organization and how Prophetstown area residents may benefit from your program.

Is the applicant organized as a non-profit organization under State and Federal laws governing charitable organizations?

Yes

Please explain and upload the specific budget for any capital project.

Are funds to be used for operating or capital expenditures?

Yes

Please explain.

Please list other funding sources available to you and amount received from each, if applicable.

Please indicate the number of area participants who benefit from your program.

List the names, titles and addresses of the applicant’s officers and governing board.

If the applicant is controlled by, related to, connected with, or sponsored by another organization, please identify the organization and explain the connection.

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Attach a copy of applicant’s proposed budget and current financial statement of the organization and a photocopy of the ruling or determination letter from the Internal Revenue Service regarding exempt status, private foundation status or grant-making status.

Maximum file size: 157.29MB

Information for Person Completing this Application

Name

Title

Date

Terms and Conditions

I hereby acknowledge the above information is correct and I am authorized to complete application on behalf of the organization.

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Community Foundation Grant Application

Organization’s Information

Upload files here

Information for Person Completing this Application

Resources

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