Name of Organization:
Contact Person:
Email:
Your Address:
Your Phone Number:
Company/Organization website:
Citizen GroupEducational InstitutionArts or Cultural OrganizationNon-Profit CorporationFor-Profit CorporationMuseum
Describe your need for financial assistance:
Describe any previous financial assistance that you have received from FWA or any other financial assistance you have received in the past:
If the financial need involves a project, outline the time frame for the project:
If any portion of your proposed project requires the services of an employee or a paid consultant, please explain the extent and cost of these services and why they are necessary:
Provide a detailed budget. List any in-kind contributions along with all sources and amounts of other financial assistance requested or to be requested from others:
Describe the results expected from your project, including any publications or reports:
Describe the benefits of your proposed project and how it will benefit the community:
