Organization InformationOrganization Name Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Organization PhoneContact Person Title Email Total Organization Budget # FT Staff # PT Staff # Volunteers # of Board Members % of Board Members who financially support the organization Mission Statement50 words or lessProvide a brief history of the organization (explain if you are part of a larger organization)100 words or lessProgram/Project InformationProject Title Project Budget Amount Requested Describe your project, service or program to a prospective donor(200 words or less)Project Purpose(75 words or less)Project Goals Outline the expected Project Outcomes(75 words or less)Project Timeline/Key MilestonesMilestoneProjected Start DateProjected End Date Provide a project timeline- beginning and ending datesCriteria and method you will use to measure your success(75 words or less)Indicate the targeted population and number of people who will be served(50 words or less)How the project addresses Hand to Hand’s Mission and/or one of the focus areas?(100 words or less)If you are serving both women/girls and men/ boys, how can your organization ensure that funds will be allotted solely for women and/or girls?(75 words or less)Total Project or Program BudgetExpense Item DescriptionEnter Amount Requested from CCF (B)Enter Amount from Other Resources (C)What are the Source of Other Income for the item (ie.fdn. grant, event income, donors)Total Budget Item B+C Please indicate that you have sent a copy of your operating budget to grants@coastalfoundation.org* Yes No CAPTCHANameThis field is for validation purposes and should be left unchanged.
