Grant Application

Organization Name

Address

Name

Title

Phone

Website

501(c)3

Yes

Public/Private Operating or Private Non Operating Charity?

Requested Grant Amount

Purpose for this Grant

How does Grant coincide with the mission statement of foundation?

PROVIDE DOCUMENTATION TO SHOW HOW FUNDS WILL BE SPENT, ACCOUNTED FOR, AND AUDITED IF NECESSARY.

GRANT FUNDS FOR YOUR CLIENTS WILL BE USED FOR EMERGENCY FINANCIAL NEED TO BE AWARDED NO MORE THAN ONCE YEARLY AND NOT TO EXCEED $500 PER CLIENT APPLICANT.

ACKNOWLEDGE ON YOUR WEBSITE THAT SEDONA, LTD. SUPPORTS YOUR ORGANIZATION.

PROVIDE TRACKING SHEET TO SEDONA, LTD. TO SHOW SUMMARY OF ACTIVITY FOR THIS GRANT AT THE END OF THIS TIME PERIOD.

PROVIDE CONFIRMATION THAT INDIVIDUALS WHO RECEIVE EMERGENCY FINANCIAL ASSISTANCE THROUGH THIS GRANT WILL BE VETTED TO CONFIRM FINANCIAL NEED.

Signature Sedona, Ltd. Board Member

Date

Month

Day

Year

Signature Sedona, Ltd. Executive Director

Date

Month

Day

Year

Grants will provide financial assistance to clients of your organization and will not be used for salaries or other operating expenses. Individual Applications to be filled out for each client.

File upload