Funding Application Please read our Application Instructions before filling out and submitting your Funding Application. Thank you! Grant Application Form Grant Application 1 2 3 4 5 6 7 Name of Organization:*Contact:* First Last Email:* Address:* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone:* Project Name:*Funding Request Amount: (e.g. 100.00)*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.):*Do you submit a 990 to the IRS? Yes No If Yes, what type of form?* Short Long If No, then please explain:*2. Describe the specific project for which you are requesting funding and specifically how the money will be used:*3. Is this a new venture or an expansion of an existing project?* 4. If money is awarded, what is the projects' timeline for implementation?*5. Briefly describe both the immediate and long-term results anticipated from this project?*6. Name other organizations, if any, you will work with on this project?* 7. What other funding sources do you have, or plan to approach for this project?*8. How will this project be funded in the future?*9. If Service League provided only a portion of your request, what would happen to this project?* 10. If money is awarded, how will you promote that Service League was the sponsor (press release, newsletter, etc.)?*11. Would there be an opportunity for Service League members to volunteer or be on the supervising body of your organization?* Prepared by:* First Last Date:* Title:*Preparer's Signature*Submitted by:* First Last Date:* Executive Director or CEO's Signature:*Sign name above using mouse or touch padExecutive Director or CEO's Name:*Supporting Documents: Project Budget, IRS 501(c)3 Determination Letter or Exemption Letters. SEE INSTRUCTIONS FOR REQUIRED SUPPORT DOCUMENTS. (If Applicable) Drop files here or Preview Your Submission The information you've entered is below. Your application has NOT been sent yet. You must scroll to the bottom of the page and click the Submit button to complete this process.{all_fields}Submission Date CommentsThis field is for validation purposes and should be left unchanged.