Nehemiah Community Foundation
Grant Request Application

Please read the information about applying for grants available on this website before completing this form. The maximum number of characters (including any spaces) for each entry is specified and cannot be exceeded. In order to be considered for funding all sections of this form must be completed. If information is missing, or you cannot provide the required information, your application will not be reviewed. If your organization is selected to receive a grant award, notification of the award will occur within six months of the Foundation’s receipt of the grant application. The email address you enter will be used by the Foundation to respond to your application. At the end of this form, you will be prompted to upload a copy of your organization’s IRS 501(c) (3) tax exemption letter, Current Financial Statement, the Grant Request Project Budget Worksheet. Any attachments you provide will not be returned.

If you have questions regarding the information required for any section of this form, please contact the Foundation by email at grantsupport@ncf-wep.org or by telephone (916) 231-1701.

All required fields are noted with an asterisk (*)

Nehemiah Community Foundation Grant Application

Non-Profit Organization Profile

Legal Name of Organization*: Required
Application Date:* Required
Address:* Required
City:* Required
State:* Required
Zip Code:* Numbers ONLY. Required
Phone:* Numbers ONLY. Required
Fax:* Numbers ONLY. Required
Website*: Required
IRS 501(c)3 Ruling Approved:*    Required
Year Founded:* Numbers ONLY. Required
EIN Number:* Numbers ONLY. Required

Primary Contact Information
First Name:* Required
Last Name:* Required
Title:* Required
Phone:* Numbers ONLY. Required
Fax:* Numbers ONLY. Required
Email:* Valid Email Required

Board of Directors Information
First Name:* Required
Last Name:* Required
Office Title:* Required
Current Employer:*

 Required
First Name:
Last Name:
Office Title:
Current Employer:

First Name:
Last Name:
Office Title:
Current Employer:

First Name:
Last Name:
Office Title:
Current Employer:

Project Information
Name:* Required
Proposed Duration
of Project in Months:*		 Numbers ONLY. Required
Project Start Date:* Required
Project Status:*     Required
Amount of Funding Needed
to Successfully Complete Project:*		 Required

Amount of Funding the Organization
has Obtained or Plans to Obtain
from Other Sources:*

 Required
List Additional Sources of Funding and the Requested Dollar Amount for the Past Year (Include projected, pending, and approved requests): *
Required
Brief Project Narrative (This narrative should explain how the project fits into the mission of the Foundation, demographics of the population to be served, the need for the project in the targeted community, and what you plan to achieve through the successful completion of this project.) Up to 1000 characters: *
Required
Detailed Description of the Project (Include how the project will be carried out, list the key steps (milestones) that are necessary for completion, and evaluation criteria that will be used to determine project success.) Up to 1500 characters: *
Required
Executive Director Biography (up to 800 characters): *
Required
Upload the following documents for your organization:
Current Financial Statement:* Required
501 (c)(3) Exemption Letter:* Required
Budget Worksheet:* Required
    
  (Please be patient. Submission make take a few minutes.)