The B and E Collins Foundation

Grant Application to the B & E Collins Foundation

For a grant request to be considered:

Please e-mail your cover letter to the B & E Collins Foundation Board President: robertm765@msn.com

three weeks before the Board Meeting

Complete the application and e-mail it to  robertm765@msn.com

2 weeks before the Board Meeting.

The Foundation considers grant applications only from Board sponsored 501c3 organizations

public charities as defined under the Internal Revenue Code and applicable regulations.  An applicant must have obtained a 501(c)(3) determination letter prior to submitting an application.

Date: ______________

1. Organization name: ___________________________

Address & Phone#:     ___________________________

___________________________                           ___________________________

3. Contact Person & Title: _________________________________

4. Person responsible for the program________________________

Phone # __________________

5. Total Agency Budget: __________________

Program Budget: ___________________

Amount Requested: _________________

6. Project Title: _______________________

Project Start Date: ______________

7. Is this a new program for your organization? Yes____ No____

8. For entire organization: Fund raising costs $___________ %_____

Administrative costs $___________ % _____

9. Projected next year’s operating budget for entire organization:

$___________

Fund raising costs  $___________ % ________

Administrative costs $___________ % ________

10. Date on which fiscal year begins _______________

11. Type of request:

____ General support      ____ Start-up costs

____ Project support      ____ Technical assistance

____ Endowment          ____ Capital expenditures

____ Other

12. Principal sources of support:

_____% United Way/SCFD _____% Government contracts

_____% Foundations/corporations     _____% Earned income

_____% Individual contributions

13. Purpose of request.

14. Why is this program unique? Why is it needed?

15. Summarize the organizations’s history, mission, and goals.

16. List any other organizations in the area with a purpose

similar to your organization and describe the collaboration, if appropriate.

17. Describe what changes will occur as a result of your program.

18. Describe your plans for sustaining the program (funding

and other sources).

19. Funding sources and amounts applied for, received, or committed.

20. Please enclose the following information with this application:

APPENDIX A: A complete budget for the project or program.

APPENDIX B: The current annual operating budget; include in-kind

Services and volunteers’ hours contributed.

APPENDIX C: Current Board of Directors, listing business addresses and occupations.

APPENDIX D: Current audited financial report.

APPENDIX E: A copy of the organization’s IRS 501(c)3 determination letter.