Community Grant Application to promote equity for women and girls

Application Date

Legal Name of Organization*

Organization EIN (proof of non-profit status)*

Contact Person (Name and Title)*

Address (Street, Apt. #)*

City/State/Zip*

Telephone*

Email*

Organization Mission Statement*

Organization Website

Program or Service Description*

State the Objectives of the proposed program or service.*

Who will this program serve (special populations, geographic area, community focus, organizational focus)?*

What are the dates encompassed by the program/service?

Start Date*

End Date*

Other Range

What are the program/service's expected outcomes?*

How will you measure them?*

Is this a new initiative or recurring program? Please explain.*

If you receive funding from AAUW State College this year you will be asked to submit a program/service assessment to receive subsequent funds.

Total proposed program/service budget (please provide a detailed budget or attach)*

Please identify any additional sources of funding and/or fees charged for this program/service.*

Total amount of grant request from AAUW State College*

By providing your name or the name of the organization's executive director, my organization authorizes the submission of this community grant application.

Centre County Community Grant Application