Grant Application

Women's Club of Newburgh, Inc.

Organization Name

Date

Organization Address

Street Address Line 2

City

Postal / Zip code

Region/State/Province

Organization Website

Organization President/ Executive Director

Contact Name (if different)

Business Phone

501 (C) (3)

Yes

Year Established

Email Address

Cell Phone (optional)

Total Number of Voluteers

Total Number of Staff

Organizational Mission Statement

(1000 Character Limit)

Brief Description of Organization (500 Character Limit)

Organizational Non-Discrimination Policy (500 Character Limit)

List of counties served along with the percentage of clients in each county.

Program/Project Name

Amount Requested

Program/Project Summary (include the community need(s) to be addressed with goals/objectives/projected outcomes:anecdotal and/or statistical data should be included (2500 Character Limit)

List any organizations you may collaborate with on this program/project.

Did you receive a WCN Grant in May 2025?

Yes

Sustainability Summary- detail how this program/project will be sustained beyond this grant (1500 Character limit)

Upload the following documents:

Copy of organizations 501(c)3 non-profit charitable tax-exempt Department of the Treasury Determination Letter
Budget Worksheet provided on our webpage
Most recent financial statement for your organization
Current board roster with professional affiliations

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Your Signature

WCN Member Signature

Select a date