Kiwanis Club of Williamsburg

Grant Request Application
Applicant's Name:
Name of Organization Requesting Funds:
Purpose of Organization:
Who authorized this application?
Name of Chief Operating Officer:
Contact Name:
Address:
City: State: Zip:
Email address:
Phone:
Fax#
TIN# *
Amount Requested $
Date of Request: (mm/dd/yy)
Do you have bookkeeping capability? Yes      No
Will these grant funds benefit our local community? Yes      No
Can you make a report/presentation to our Club's Board? Yes      No

Type of Organization
Please provide us with a copy of your tax exempt status letter.
IRS Designated 501(c)3
IRS Designated 501(c)4
IRS Designated 501(6)
IRS Designated 501(c)19
Faith Based Organization **
Not for Profit Corporation, please include: ***
State of Organization:
Cert.#
Unincorporated Association

Purpose of Requested Funds:

* TIN number will be validated using the IRS publicly available database.

** Faith based organizations must be conducting projects that benefit the community as a whole. Grants cannot solely or primarily benefit, directly or indirectly, their adherents or members.

*** If qualified not-for-profit, you must attach certification from IRS.