Grant Form for Members

Walnut Cove Members Association

Walnut Cove Members Association

Charitable Grant Request

To be completed by the WCMA member

  • In order to submit an application, the sponsor must be a current WCMA member.
  • Because we may not have the funds available to honor all requests, the Grants Committee uses specific criteria to evaluate each applicant. It is the sponsor’s responsibility to read the guidelines and the FAQ page on our website to ensure that this request meets the stated criteria. (com)

Name, address, phone number and email of the WCMA member requesting this grant:

____________________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________

Organization Name: ___________________________________________________________________

Name, address, phone number, and email of the contact person of the organization to receive this grant:

______________________________________________________________________________________________________________________________________________________________________________________________________

Is the organization a 501c(3)? ______________

What is the mission of the charitable organization? ______________________________________________________________________________________________________________________________________________________________________________________________________

Please provide a brief description and purpose of the project for which this grant is being requested:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What is the gifting dollar amount that is being requested for this organization? (Amount should not exceed $5,000) _____________________

Does your organization meet the WCMA grant objectives as stated in the guidelines? _______________

Will this organization be generating any publicity regarding this charitable grant from the WCMA? If so, how? __________________________________________________________________

Please provide information regarding your active involvement with this charity: __________________________________________________________________

Please list other WCMA members involved with this organization, if known: __________________________________________________________________

Is there any other additional information that you wish to supply?

__________________________________________________________________

 

__________________________________________________________________

 

__________________________________________________________________

 

 

 

 

 

Please return this form no later than September 30, 2016 to:

Grants Committee Chair – Karen Spacek

1590 Country View Way Arden NC 28704

karenlspacek@aol.com

Print Friendly

Leave a Reply