Fulton Neighborhood Association Grant Application Form

The mission of the FNA grant program is to make the Fulton community more interconnected and expansive through effective support of youth programs and community engagement activities.

Organization Information

Labels with * are required fields.

Organization / Individual’s Name*:

Address*:

City*:

State:

Zip:

Telephone*:

E-Mail*:

Name / Title of Contact Person*:

Telephone and Email of Contact Person:

Total Organization budget for current year (for Businesses & Non-profits) in US Dollars($)*:

Date of Incorporation:

Is the Organization a 501(c)(3)?:

Primary Service / Industry category of Organization:

Mission of the Organization / Business:

What are the short-term and long-term goals of the Business / Non-profit / Event committee?(3-5 sentences):

Describe the current Activities / Services / Programs of the Organization (3-5 sentences):

Number of full time Staff:

Number of part time Staff:

Number of volunteers:

List and describe formal and informal relationships with other Organizations in the Fulton area:

Grant Request

Amount Requested in US Dollars($)*:

Total estimated Cost / Budget for Project / Program (beyond grant request amount) in US Dollars($)*:

Time frame in which funds will be used from*:

Target date by which funds will be used*:

Summarize the purpose of the request:

Geographic area impacted through Grant request:

How will receiving the Grant impact the Fulton Community?

How will Individuals and / or other organizations within the Fulton community be engaged to attend or support the Program / Project being supported through Grant funding?

Evaluation of the Impact of the Grant

Explain how the impact of the Grant’s funds will be measured and evaluated:

Describe the final end result you expect to achieved by the end of the grant support period:

Please attach any materials relevant to either your request or Organization (annual reports, event plans, etc.), Documents( pdf, xlx, xlsx, doc, docx) and Images( gif, jpg, jpeg, png) are acceptable with maximum size of 2MB:

Labels with * are required fields.