Grant Application | Women's Club of Newburgh

WCN Grant Application

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Organization name

Organization Address

Organization Website

Contact First Name

Contact Last name

Business Phone

Cell Phone

Organization President/Executive Director (if different from Contact)

501 (c) 3

Yes

Year Established

Total Number of Volunteers

Total Number of Staff

Organizational Mission Statement

1,000 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 last year?

Yes

Unsure? Check the list of Past Grant Recipients here.

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

Upload required documents:

Please read instruction page before submitting!

Date of Submission

President/Executive Director Signature

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