Please use this form when completing your application. Use additional sheets as needed to answer questions and indicate which Part and Question are being answered. Submit applications by June 1. Selection will be made by June 30. Applicant notified by July 31. Funds granted by September 1. Applicants not approved for funding will be notified by the end of July.

Mail the completed application to: SNEC-SWCS, P.O. Box 7641, Cumberland, RI 02864.
 
 

DATE __________________________

NAME OF ORGANIZATION ___________________________________________________

ADDRESS ____________________________________________________________________

_____________________________________________________________________________

CONTACT PERSON ____________________________ TITLE _______________________

PHONE (____) _____________________________ FAX (____) ________________________
 

PART I - INFORMATION ABOUT APPLICANT

1. Purpose of Organization.

2. Geographic area served by organization (i.e. Town, County, State)

3. Sources of present funding for the organization.

4. Are you a non-profit organization? _____ Yes _____ No

Federal Identification Number ___________________________________

Internal Revenue Service exemptions under Section __________________

(include copy of IRS letter of determination)
 

PART II - USE OF PROPOSED FUNDING

1. Purpose and use of proposed funds.

2. What portion of the total cost of the project is represented by this request?

3. Is this a one time request? _____ Yes _____ No

If no, please explain.

4. Details of any previous grants from SNEC-SWCS.

5. Have you applied for other sources of funding? _____ Yes _____ No

6. Percentage of income allocated to administrative overhead and fund raising.

7. Percentage of income applied directly to programs for which funds are solicited.
 

PART III - GRANT REQUEST

1. Amount of grant requested $___________________________

2. When are funds needed? _______________________________ (date)

3. Include project budget in detail (including any other sources of funding).
 

PART IV - ATTACHMENTS

1. Most recent audited financial statement.
2. Latest Annual Report, or if not available, a statement describing the organization's purpose and achievements.

FOR CHAPTER USE ONLY

Budget Committee recommendations: ____________________________ (date)

Board Action: _____ Approve _____ Disapprove ___________________(date)

Comments (if any):
 
 
 
 
 
 
 
 

The Southern New England Chapter - Soil and Water Conservation Society (SWCS) is exempt from federal Income Tax under Section 501(c)(3). Federal Identification Number is 04-2743085.

P.O. Box 7641, Cumberland, RI 02864