Online Grant Application

Before filling out the grant application below, please visit here for important information, policies and instructions.

* Denotes Required Fields

*Date
*Amount Requested
*Name of Organization
Contact Person
Address
*Street Address

Address Line 2

*City

*State / Province / Region

*Postal / Zip Code

*Country
Phone
Cell Phone
Fax
*Email
Is this request for capital expense item'other' purposes
I. Describe how these grant funds are to be used.
II. If a capital expense item, describe where item(s) will be placed in service and how it will be used.
III. Explain how this item or funds will be used to enhance your organization’s operation.
IV. List projected expenses for this request. How are cost estimates determined? If needed attach a file below.
Attach any available quotes for this purchase. Limit attached estimates to one page.

Must be in PDF, Microsoft Excel or Microsoft Word Document format.
V. Briefly tell about your organization. (Include whom your organization serves, any benefits to residents of Jefferson County and the number of residents who will be affected by the awarding of this grant.)
VI. If your grant request is for other than a capital asset purchase, please attach a copy of the organization’s most recent balance sheet, statement of revenues and expenditures, and future sustainability plan.

Must be in PDF, Microsoft Excel or Microsoft Word Document format.

Balance Sheet
Statement of revenues & expenditures
Future sustainability plan
VII. Are you incorporated? yesno
Are you tax exempt? yesno
You must provide verification of your non-profit status. Provide us with a letter of determination from the IRS on your 501(c)3 status if you have applied for and received one. Attach a copy of the letter to this application below. (This is NOT your tax-ID number) If you are a city/county entity, a verification letter is required to be attached to this document.

Applications will not be considered unless there is an IRS Determination Letter attached to the application, whether 501©3, Organization sponsored by the City or County Gov’t, etc...

Verification of your non-profit status.

Must be in PDF, Microsoft Excel or Microsoft Word Document format.
VII. Can your organization complete your project if GJCF partially funds your grant request? yesno
The EIN (Employer Identification) Number (also known as Tax ID #) of your organization is: (this is NOT your IRS Status)
Budget Summary:
*Grant Request Amount
The dollar amount requested from the Foundation.
*Grant Request Amount Percentage
%The precentage amount requested from the Foundation.
Other Funds:
Monies other than the requested grant above. It means funds that are received from other grants, the City, the County, a private donation, etc.
Other Funds Precentage:
%The precentage of the above "Other Funds."
Are other funds committed?
Does your organization have the other funds in hand? Do you have a letter of commitment stating that those dollars are available to you? Is that portion of the money in your budget or elsewhere in the organization’s budget?"
yesno
Other Funds
Monies other than the requested grant above. It means funds that are received from other grants, the City, the County, a private donation, etc.
Other Funds Precentage:
%The precentage of the above "Other Funds."
Are other funds committed?
Does your organization have the other funds in hand? Do you have a letter of commitment stating that those dollars are available to you? Is that portion of the money in your budget or elsewhere in the organization’s budget?"
yesno
Applicant Funds
Is the amount of monies your organization has or is raising from your own sources (money on hand, dues, bake sales, fund raisers, etc.)
Applicant Funds Precentage
%The precentage of the above "Applicant Funds."
Are Applicant funds committed?
Does your organization have the funds in hand? Is that portion of the money in your budget or elsewhere in the organization’s budget?"
yesno
Total Project Cost
Has the Applicant applied for funds for this project from any other sources? yesno
If Yes, how much?
Was/is the request approved, rejected or pending? approvedrejectedpending
If rejected, why?
If the request is funded, who will operate and maintain the improvements?
Has the project started? yesno
When will the project start?
List the amount of Grant Funds received from the Greater Jefferson County Foundation by your Organization / Entity during each of the past three (3) years:

Year 1
Year 2
Year 3
*Your Full Name
*Your Title
By checking the box below, you acknowledge that all of the statements and representations in the application are true and made for the purpose of obtaining a grant. Greater Jefferson County Foundation is authorized by you to obtain information about you as a grant applicant, consistent with your privacy rights and the foundation grant procedures.
*I have read the above, understand the same, and consent thereto.

Online Grant Application

Budget Summary: