Community Needs Grant Assistance Registration Form

Please compete the following form to request assistance with your Community Needs Grant Application.

Fields marked with an * are required.

Organization *

Name of Executive Director *

What is the first and last name of the primary point of contact? *

What is the title of the primary point of contact? *

What is the phone number of the primary point of contact? *

What is the email of the primary point of contact? *

What is your approximate annual budget? *

Please note that eligibility for this grant are those organizations with an annual budget between, $25,000 and $750,000.

Are you available during regular business hours to meet via ZOOM for technical assistance? *

If yes, please check.

If you answered No to the previous question please note your availability to meet.

Are there any specific areas with which you would like assistance with the grant application?

If there is specific assistance you have in mind, please indicate.

Website

If you organization has a website, please provide the URL