Funding Application

Name of Organization:(Required)
Contact:(Required)
First Last
Email:(Required)
Address:(Required)
Street Address Address Line 2 City State ZIP Code
Phone:(Required)

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Project Name:(Required)
Funding Request Amount: (e.g. 100.00)(Required)
Number must be in this format: 100.00 (no dollar sign)
1. Describe the purpose and structure of your organization (i.e. Board of Trustees, etc.):(Required)
Do you submit a 990 to the IRS?(Required)
- Yes
- No
If Yes, what type of form?(Required)
- Short
- Long
- Not Applicable
If No, then please explain:(Required)
2. Have you received a grant from WRJSL in the past?(Required)
- Yes
- No
If yes, when:
3. Describe the specific project for which you are requesting funding and specifically how the money will be used:(Required)
4. Is this a new venture or an expansion of an existing project?(Required)

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5. If money is awarded, what is the projects' timeline for implementation?(Required)
6. Briefly describe both the immediate and long-term results anticipated from this project:(Required)
7. Name other organizations, if any, you will work with on this project?(Required)

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8. What other funding sources do you have, or plan to approach for this project?(Required)
9. How will this project be funded in the future?(Required)
10. Approximately how many people will benefit from this project?(Required)
11. If WRJSL provided only a portion of your request, what would happen to this project?(Required)

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12. If money is awarded, how will you promote that WRJSL was the sponsor (press release, newsletter, etc.)?(Required)
13. Would there be an opportunity for WRJSL members to volunteer or be on the supervising body of your organization?(Required)
14. How did you learn that WRJSL provides grants?(Required)

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Prepared by:(Required)
First Last
Date:(Required)
MM slash DD slash YYYY
Title:(Required)
Preparer's Signature(Required)
Submitted by:(Required)
First Last
Date:(Required)
MM slash DD slash YYYY
Title:(Required)
Executive Director or CEO's Name:(Required)
Date:(Required)
MM slash DD slash YYYY
Executive Director or CEO's Signature(Required)
By checking here, I affirm that the CEO/Executive Director is/are aware of and support this grant application and that all facts, figures and representations made in this application are true and correct to the best of my knowledge.(Required)
- Check here
Supporting Documents: Project Budget, 2 Written Quotes for Project, IRS 501(c)3 Determination Letter or Exemption Letters. SEE INSTRUCTIONS FOR REQUIRED SUPPORT DOCUMENTS. (If Applicable)(Required)
Drop files here or

Max. file size: 50 MB.
Submission Guildelines Checklist; Make sure your application includes the following:
- Grant Application Form
- Application is acknowledged by the Preparer and CEO or Executive Director
- Detailed project budget that ties to your grant request
- A copy of the most recent annual budget
- Project cost documents including at least 2 quotes/bids
- 501(c)3 IRS final determination letter (Note: Not your sales tax exempt form from the state of Ohio) or an unexpired advanced ruling letter from the IRS or a letter from the IRS confirming 501(c)3 status.
- For public schools, a signed copy of the Non-Profit Certification Letter may be substituted for IRS determination letter
- For a group exemption organization, a letter from the parent organization must also be included.
ONCE YOU SUBMIT YOUR APPLICATION, NO CHANGES CAN BE MADE.

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Funding Application

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