Action Grant Application Action Grant Application Organization/Individual's Name(Required) Mission Statement:(Required)Project Goal:(Required)Amount of this request:(Required)Total cost of project:(Required)Project Description:(Required)Project Start Date(Required) MM slash DD slash YYYY Project End Date(Required) MM slash DD slash YYYY Contingency Plan(Required)If full funding is not received, what is your contingency plan for your project?Examples of Past Projects(Required) Drop files here or Select files Max. file size: 300 MB, Max. files: 3. Attach one of the following: resume, Board of Directors list, or letter of support from community/organization leader(Required)Max. file size: 300 MB.Name of authorizing official(Required) First Last Phone(Required)Email(Required) Mailing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Certification(Required) I certify that the information contained in this application, including all attachments and supporting materials, is true and correct to the best of my knowledge.Signature(Required) Reset signature Signature locked. Reset to sign again
