Please print out below form, fill it out, sign and date.
Please send this form and Use of Funds Report Form together as soon as possible. Thank you!
To be considered for funding, you must complete this application. The deadline must be postmarked by Friday April 14, 2017.
Applications received after this date will not be considered.
- Name of Organization submitting request: _____________________________
- Amount Requested: _______________________________________________
- Contact Person:___________________________________________________
Briefly describe the needs for which you are requesting this grant:
Who will benefit from this grant ?
How many individuals will benefit from this grant? _______________
- Please include a copy of the total Program Budget for this project: Attach a separate sheet with program budget listing items separately, ie: program name, staff, supplies, utilities, etc
- Enclose a copy of your 501c3 letter or the name of your fiscal agent.
Qualifying Participants: In order to be eligible for funding, someone from your organization must be an active participant in one of the following committee(s) and or a member of the board.
Listed below are the committees and board. Please add their name(s) to the participating committee/Board of Directors.
Board of directors:________________________________________
Step Out Site :____________________________________________
Please return to:
Annual Good Friday Walk
c/o John Lawlor
PO Box 72830
Providence, RI 02907