Grant Application for Entities Other than State AG Offices

All sections are required. An incomplete application will be delayed.
Grant Request (required)

Organization (exact legal name) to which grant would be paid: (required)

Your name

Your title

Your address

Your telephone

Your email

Is your organization an IRS 501(c)(3) not-for-profit?yesno
If yes, please attach (docx, pdf, or txt format) evidence of status:
If no, please explain:

Proposal Description:

Proposal Summary:

Please explain briefly why you are seeking this grant, what outcomes you hope to achieve, and how you will spend the money if the grant is made.

or you can submit a document (one page maximum) (docx, pdf, or txt formats)

Proposal Specification:

Or you can submit a document providing Information about your Organization, details about your funding request, and evaluation criteria. (five page maximum) (docx, pdf, or txt formats) see below

Information About Your Organization

A brief description of your organization's history and mission.
A summary of current or recent programs and accomplishments.
The number of staff (indicating full-time, part-time and volunteer).
Any relationships your organization has, formal and informal, with other organizations having a similar mission.

Details About Your Funding Request

A statement of the purposes of the project for which you are seeking the grant.
How you intend to implement the project.
The estimated total cost of the project and other anticipated funding sources.
How you intend to staff the project.
The anticipated length of the project.
How you propose to spend the funds you are seeking from the State Center.
How the project supports the State Center's mission.

Evaluation

Please explain how you will measure the effectiveness of the project for which you are seeking the grant. Describe your criteria for success and the results you hope to achieve.

or you can submit a document providing Information about your Organization, details about your funding requestion, and evaluation criteria. (five page maximum) (docx, pdf, or txt formats)

Please also attach and submit in (docx, pdf, or txt formats):
1. Audited financial statements for the past two fiscal years.
2. An organization chart.
3. Biographies of your Executive Director and members of your Board of Directors
4. A proposed budget for the project for which you are seeking funds from the State Center

Your application will be submitted to the State Center's Executive Director, by e-mail.