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Boyertown Area Charitable Giving Program Grant Application
Grants from the Boyertown Area Charitable Giving Program are investments in our community. Please submit this form to apply for a grant from this program. Applications are reviewed each September.

Application deadline is August 25, 2008.

Please note the following eligibility requirements:
Tax-exempt or public benefit organizations, individuals, associations and private or public agencies are eligible to apply. The grant must be used for charitable purposes only. Organizations are eligible to apply to more than one grant program in the same year.

Organization requesting grant:  

Contact Name: 

Prefix
First
MI
Last
Suffix
 
 
 
 
 

Title (if applicable): 
 

Street Address:
 

Address 2 (optional):
 

City:  

State:   Zip Code:   County

Phone Number (xxx xxx-xxxx):   extension: 

Fax Number: 

Email address 

Organization's website address (if applicable):  

Date (mm/dd/yyyy):  

Are you a/an:

501(c)(3) organization
Individual
Church
School
Government Entity
Other
 

Program/Project Name:  

Amount of Request (amount of money you are asking the Charitable Giving Program for): 

Total Project/Program Cost (Total cost including funding from other sources): 

Purpose of Grant Request (one sentence):

 

Briefly explain how the project will operate (two-three paragraphs):

 

How many people in the Boyertown area will be influenced by your project?  

Please attach a budget worksheet that shows the project's expected income and expenses, including other sources of income. Note the specific expenses to be covered by these grant funds. 

How did you hear about the Community Foundation?