Grant Application : Grant Application : Provide Educational Services, INC

Grant Application

Download Financial Report Template

You will need to provide a financial report to complete this application. For a sample template of revenue, follow the link for a downloadable file.

Date of Application

Month

Day

Year

Legal Name of Organization (Required)

Should be the same as on IRS determination letter and as supplied on IRS Form 990

Year Founded (Required)

Current Annual Operating Budget (Required)

Executive Director (Required)

Executive Director Email (Required)

Contact Person's Information

Name

First Name *

Last Name *

Title

Address (principal/administrative office)

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Mailing Address (if different than above)

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Phone (Required)

Fax

Website Address

Project Name (Required)

Purpose (Required)

Amount Requested (Required)

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Total Project Cost (Required)

Project Goals (Required)

Beginning Date of Project/Campaign

Month

Day

Year

End Date of Project/Campaign (Required)

Geographic Area to be served (Required)

Required Information

Mission Statement (Required)

Board of Directors (Required)

By Submitting this form, I certify, to the best of my knowledge, that:

1. The tax-exempt status of this Organization is still in effect,
2. This Organization does not support or engage in any terrorist activity, and
3. If a grant is awarded to this Organization, the proceeds of that grant will not be distributed to or used to benefit any organization or individual supporting or engaged in terrorism, or used for any other unlawful purpose.

PROVIDE EDUCATIONAL SERVICES, INC shall be operated exclusively

For educational and charitable purposes.