2025 Otto Bremer Trust Community Responsive Fund Grant Screening Questionnaire

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

Are you a 501(c)3 Nonprofit Organization?

You must be a 501(c)3 Nonprofit Organization

Federal TX ID Number (EIN):

Please include numbers and dash. Example: XX-XXXXXXX

Organization Name:

Street/Mailing Address

City

State/Province

Zip Code

What county within the Southwest Initiative Foundation Region is your headquarters located in:

Organization Phone

Year Organization was Incorporated:

Must have at least five years of successful operations. For the year, enter a four-digit number (e.g., 2019)

What were your last fiscal year’s actual expenses?

Must be $2 million or more. Enter the amount as a number without a dollar sign ($) or commas (,). Decimals are allowed (e.g., 200000.50)."

Please Select all that apply the category(ies) that your mission/project aligns with, you may choose multiple options.

Literacy. Organizations and programs advancing literacy.Adoption and foster care services. Organizations and programs

that support adoption and foster care.

Children’s health. Organizations and programs that provide

health-related access and services for children.

Children’s disability services. Organizations and programs

focused on supporting children with physical/cognitive disabilities.

Mental health. Organizations and programs that support access

to and delivery of mental health services, with preference given

to work that addresses the needs of children aged 5-15.

Capital projects for hospitals and clinics. Activities supporting

the maintenance of hospitals, construction of facilities, and

purchase of medical equipment.

Please upload your most recent 990 Form.

Please select

Impact Category

Campaign

Stage

Tag and Form ID for Active Campaigns

Program Fund Areas

Southwest Initiative Foundation is a nonprofit community foundation connecting people, investing in ideas and building communities to create a southwest Minnesota where all people thrive. Learn more at swifoundation.org.

Southwest Initiative Foundation | 15 3rd Ave NW Hutchinson, MN 55350 | (320) 587-4848 | info@swifoundation.org
Copyright © 2020 Southwest Initiative Foundation, an equal opportunity provider and employer.