Grant Form for Members

WCMA Grant Application 2017 for WCMA Members

WCMA Member/Sponsor Information

Name  
Address  
Email  
Phone  
Date of Request  
Grant Amount Requested

(Max Amount $10,000)

 

Organization Information

Organization Name  
Contact Name  
Address  
Contact Email  
Contact Phone  
501c(3) Status  
Grant Amount Requested  

Grant Request Information

Summarize the mission of the charitable organization.

 

 

 

 

Summarize the program for which this grant is being requested.

 

Describe how WCMA will be recognized if a grant is awarded.

 

Provide information regarding your active involvement with this organization.

 

List other WCMA Members involved with this organization.

 

Provide any additional relevant information regarding this request.

 

Agreement

By submitting this application, I affirm that the facts set forth in it are true and complete and the organization meets the WCMA grant guidelines.

Name (printed)  
Date  

Grant Submission Information

Please submit this form no later than Monday, October 23, 2017 to:

Karen Spacek, Grant Committee Chair

1590 Country View Way Arden NC 28704

karenlspacek@aol.com

 

 

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