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Grant Application
Please submit your
grant application with no more than 5 pages of supporting or explanatory
information. If your application fits with SVCF priorities, we
will contact you for additional information. We are sorry, but we
cannot accept telephone inquiries about grant applications at this time
in the development of the Foundation. Grant applications may be
submitted by mail to SVCF, 4200 Rosemary St., Chevy Chase, MD 20815, or
as an attachment to an email addressed to jeff.svcf@att.net.
Date: ____________________
1. Name of Applicant Organization:
_________________________________________________
_________________________________________________
Street Address:
_________________________________________________
_________________________________________________
Town/City: ________________________________________
State: _______
Zip: ______________
Phone: ( )__________ Fax: (
)____________
E-mail: _________________________________
Name and title of
person applying for the grant on behalf of the applicant organization:
________________________________________
________________________________________
2. Is the applicant organization tax-exempt: Yes __
No ___ Application Pending ____
If yes, please list Employer Identification Number:
_________________________________________________
and submit copy of IRS tax-exempt status
determination
letter.
3. Charitable or Educational Mission & Purpose of Organization
(include identification of the
principal challenges to be addressed):
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
4. Amount of grant request:
$________________________________________________
5. Purpose for which grant is requested
(Explain how the grant will help the applicant
organization become more entrepreneurial and self-sustaining and/or carry
out its charitable or educational mission and purpose more effectively?):
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
6. Metrics (outcome measures) to be used in evaluating the near-term or longer term success of the organization:
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
7. Metrics (outcome measures) to be used in evaluating the success of the project for which the grant is being sought:
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
8. Pre-project baseline data on the organization and project pertinent to the above
metrics (outcome measures):
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
9. Accomplishments of applicant organization and/or
leadership:
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
10. Any other comments pertinent to SVCF's Grant
Guidelines or Evaluation
Criteria:
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
11. Names, addresses,
and resumes of Board members and key staff (to be submitted as
attachment)
In submitting this grant application, I affirm that any funds granted pursuant to this application will be spent solely for the purposes set forth in this application and in accordance with applicable requirements of the Internal Revenue Code of the United States.
I agree to abide by all record keeping and reporting requirements of the SVCF necessary to ensure compliance with this pledge.
I also agree that the organization for which this grant application is
being filed will participate in the SVCF Mutual
Support Network.
Signature of Officer Applying for Grant:
_________________________________________________
Name of Officer Applying (please print):
_________________________________________________
Title: _____________________________________________
List of Supporting Material Submitted with Grant Application:
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
__________________
Note: In submitting this application I understand that The Social Venture Capital Foundation, Inc. (SVCF) may
be unable to respond to this submission, and that
its ability to make grants depends on the availability of funds and other competing
needs.
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