CFGL - Grant Request

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Grant Request


Date:
Name of Fund:
Amount of Grant Request:
Organization to Receive Grant:
Specific Designation for Expenditure of Grant Check:
Contact Organization:
Street:
City:
State:
Zip Code:

This grant check is to be sent anonymously::	Yes No
Details of this grant request may be used for publication by CFGL::	Yes No
Details may be used but keep donor's name anonymous::	Yes No
For a grant with a "Specific Designation," the Community Foundation can request program outcomes and a final budget. Would you like this done on this grant?:	Yes No
I/We will not receive from this grant any goods or services having more than an insubstantial fair market value.:
I/We will waive all goods and services associated with this grant.:
I/We have attached a check to cover goods and/or services associated with this grant.:

Comments:

Signature of Advisor:
Signature of Advisor:
Signature of Advisor:

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