Grant Application Form: Grant Application Form

Organization Information

If you are a department or division of a larger organization, please check with your administration before submitting to make sure you follow existing rules and practices. The grant may need to be submitted under the name of the parent organization.

Organization name *

Organization address *

City *

State/Province *

Zip code *

Contact Person

Your name *

Your email *

Address *

Phone number *

If funded, would you prefer a paper check or an Electronic Funds Transfer?

Have you received a previous grant from Believe in Reading and if so, for how many years?

Project Information

Description of project to be funded *

What is your timeline? *

What measurable outcomes do you expect if your program is successful? *

What is your projected cost per person served? *

What is your track record? *

How will you share your program with the world? *

How did you hear about Believe in Reading?

Amount of Funding Requested

Funding per Year *

Number of Years (3 Years Maximum) *

Itemize how the funds will be spent *

Other

Federal Tax ID or EIN (use the format: 00-0000000)*

Organization director

Program director

Board member

Additional Paperwork

Acceptable file types (extensions) are: jpg, jpeg, png, gif, pdf, doc, docx, ppt, pptx, odt, avi, ogg, m4a, mov, mp3, mp4, mpg, wav, and wmv. Maximum file size is 1 MB. Please contact us via email if you need to submit documentation in a different form.

Brief history of organization (including statistics of success for the specific program to be funded if the proposal is to fund a program already in place):

Proof of tax exempt status:

Most recent audit (if applicable):

Detailed organizational budgets for the past two years (not necessary for public or school library applicants):

Demographics (especially poverty level), and reading proficiency scores for the target population of the proposed project: