Affiliate Grant Application

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You are applying for a grant from the

Cottonwood Area Community Foundation Endowment

Primary Contact Information

Person Completing Grant Application for the Organization

First Name:

Last Name:

Title:

Preferred Email:

Email:

Preferred Phone Number

Work Phone Number:

Home Phone Number:

Mobile Phone Number:

Grant Project Contact-Opportunity Contact Role

Organization represents a:

Due to IRS regulations, your application requires a "fiscal sponsor" partnership. Enter your organization's fiscal agent info in the section below.

Fiscal sponsor secured and entered below

Organization Information

Federal Tax ID Nonprofit Number (EIN):

This is the Federal Tax ID Number, also known as an EIN Employer Number. Nonprofits, Schools and Government Entities have them. (Not a State ID Number.)

Organization Name:

For the top staff person at the above organization

Contact Information

First Name

Last Name

Title

What sector does organization serve?

Organization Phone

Street Address for the Organization

City

State/Province

Postal Code:

County

Website for Organization:

Generic Email Address for Organization:

Area Organization Serves:

Use "Ctrl" to select multiple Counties.

Fiscal Sponsor Information

Due to IRS regulations, your application will require a "fiscal sponsor" partnership. A fiscal sponsor is a non-profit entity (i.e. a 501(c)3 public charity, a unit of government or a public agency) that accepts responsibility for the project/activities of an organization that does not have tax-exempt status, but whose project clearly demonstrates a public benefit.

Fiscal Sponsor Organization Name:

Fiscal Sponsor Organization represents a:

Fiscal Sponsor Federal TX ID Number (EIN):

This is the Federal Tax ID Number, also known as an EIN Number. (Not a State ID Number.)

Organization Website:

Generic Email Address for Organization:

Enter only email addresses such as "info@".

Contact First Name:

Contact Last Name:

Contact Title:

Work Email

Contact Work Phone:

Fiscal Sponsor Mailing Street Address:

City:

County:

State/Province:

Postal Code:

Organizational Background:

Proposed Project Information

Project Title:

A 1-3 sentence summation of the project

Project Description and Expected Outcomes: (3-4 Sentences)

What our grant dollars would be used for:

Other sources of funding and project partners:

Total Project Budget $:

Enter amount, no dollar sign.

Requested Amount: $

$500 or more.

Project Start Date:

Select calendar date

Project End Date:

Select calendar date

Indicate the projected number to be served by your project:

Communities

Enter an estimated number not a range.

People

Enter an estimated number not a range.

Agencies

Enter an estimated number not a range.

Businesses

Enter an estimated number not a range.

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Supporting Information:

Supporting documents for the organization or grant application can be uploaded here.

Read the following 3 steps to fully sign and submit the grant:
1. Click Submit Below
2. Complete your E-Signature
3. Confirm your E-signature using the link in the email you will receive after signing. Check spam/junk folders if you don't see it within a few minutes.

*Grant is not signed or submitted until you click the verification link in your email inbox that confirms your e-signature.*

Active Campaign Tag

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Contact Information