Grant Application Part 1

Grant Application– Part 1

Please read our “Grant Guid e lines” page before filling out application.

IRS 501 (C)(3) Organization
Donations are tax deductible

Date of Application
Legal Name of Organization Applying
Should be the same as an IRS determination letter and as supplied on IRS Form 990
Year Founded
Current Operating Budget
Executive Director
Executive Director Email
Contact Person
If different from Executive Director
Contact Person Title
Contact Phone
Institution Address 1
Institution Address 2
Principal/administrative office - cannot be PO Box
City
State, ZIP
Daytime Phone
Fax
Contact Email Address
Website
Previous DIS Grants
List any previous support from DIS in the last five years - include $ amount and name of project supported.
Project Name
Purpose of Grant (One sentence)
Dates of the Project
Amount Requested
Total Project Cost
Geographic Area Served
Number of Children Served
Tax Exempt Number

Save and Continue Later

Please visit our Grant Application Part 2 page for additional information
that needs to be submitted.