Otto Bremer Trust Community Responsive Fund

Primary Contact Information for this Grant Application

First Name

Last Name

Title

Work Email

Work Phone Number

Cell Phone Number

Opportunity Contact Role

Organization Information Requesting the Grant

Organization represents a:

Due to IRS regulations, your application requires a "fiscal sponsor" partnership. Check here to enter your organization's fiscal sponsor info below.

Fiscal sponsor secured and entered below

Federal TX ID Number (EIN):

What sector does organization serve?

Organization Name:

Street Address

City

State/Province

Postal Code

County

Organization Phone

Year Organization was Incorporated:

Organization Mission:

Organizational Background:

5,000 characters max

Most Recent Fiscal Year Gross Revenue (rounded):

Current FTEs and Equivalents (estimate):

Estimated number of Full Time Employees

Organization's Primary Programs, Services, Activities:

Organization's Geography (county) Served:

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Other

Manually input the community name(s)

Website

Organization's Communities Served:

Use "Ctrl to select multiple Communities. If the community you are looking for is not listed, please choose "Other" and manually input the community name.

Generic Email Address for Organization:

Is Organization is a Current Otto Bremer Trust grantee:

Eligibility area(s) of Otto Bremer Trust Grantmaking Served, Select all that Apply:

Basic needs Community asset building Health + wellbeing Restorative + responsive

Project Information

Project Title:

Project Summary:

Project Description:

Goals and Expected Outcomes:

Indicate the projected number to be served by your project:

Agencies

Businesses

Communities

People

Project Start Date

Project End Date

Amount: $

Minimum $500

Total Project Budget $

Other sources of funding:

Need Addressed/Impact: What need are you addressing? Describe the impact of the proposed work.

Approach: Describe how your approach is based on established best practices that will most likely lead to desired outcomes.

Partners: Who are the partners involved your work?

Creating Belonging: How does your organization or project engage diverse voices and experiences?

Sustainability: What are the long-term strategies for sustainability? (optional)

Miscellaneous: Include any other information you would like to provide. (optional)

Documentation

Southwest Initiative Foundation would like to review your project budget. Please download the Excel template below, complete and upload the finished document. Other documents can be uploaded in the appropriate places.

Project Budget and Narrative (Template attached to email notification or Download this Excel Template, complete form and re-upload with project data):

Letters of Support:

Optional

Miscellaneous Documents:

Optional

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Impact Category

Campaign