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REQUEST FOR STONEY’S KIDS LEGACY SUPPORT

NAME OF PROJECT: NAME OF ORGANIZATION: CONTACT PERSON / TITLE: SIGNATURE OF AUTHORIZED PERSON: PRINT NAME & TITLE OF AUTHORIZED PERSON:

ADDRESS: /

/

Phone:

E-Mail:

AMOUNT REQUESTED:

Website: PAYABLE TO:

Is your organization a registered 501C3 charity? Yes______

__________ no______

What is your charitable registration number? _______________________________________________ If not, is your proposal being sponsored by another registered 501C3 charity? Yes_____ No ____ If so, are you and your sponsor fully aware of the requirements and responsibilities of such a sponsorship arrangement? Yes _____ No _____ If you are being sponsored by another registered charity, please complete this section: Name of sponsoring organization _______________________________________________________ Contact person for this proposal ________________________________________________________ Phone number ___________________ email: ____________________________________________ What is your mission statement: _________________________________________________________ ___________________________________________________________________________________ 1)

Please describe your program or project your organization or enhance its activities, number of kids that will benefit? o

How are these children selected?


o

Is this grant benefiting underprivileged children? Are all of the children benefiting unable to pay for the event?

o

Are children receiving a full scholarship to attend this event? Yes ____ No ____

o

Budget including salaries for this project and/or your organization, please attach to this request.

o

Will equipment be purchased with this grant, if so what type of equipment and how many pieces? Attach copies of the purchase cost for each item.

o

How will your event further the ultimate mission of Stoney’s Kids Legacy by strengthening and enhancing the quality of life for underprivileged children?

2)

Please give the time frame in which the funds will be used. (Must be current year only)

3)

Has this project or your organization received support from Stoney’s Kids/Stoney’s Kids Legacy in the past? If so, how much funding was received and how were the funds used previously?

4)

Will support from Stoney’s Kids Legacy help your organization secure additional support or will this contribution be combined with donations from other organizations to maximize effectiveness?

5)

What is the anticipated outcome from your project, including how many individuals will benefit from this program?

6)

What historical data can you provide about the success of your event:

7)

How will you recognize Stoney’s Kids Legacy for this project?

Stoney’s Kids Legacy does not fund for administrative costs. Should your request be granted, an accounting of the use of funds and a summary of the outcome of the project must be provided within 60 days of the project’s completion. Grant applications will be received by email to: info@stoneyskidslegacy.org

Note: Add attachment if additional space is needed.www.stoneyskids.org

071916 skl grant request form  
071916 skl grant request form