Andrews Foundation
Grant Application
1. Organization's Name:_____________________________________Date:______________
2. Address:________________________________________________________________
City:_______________________ State :_____________ Zip:________________
3. Contact Person & Title_______________________________
Phone #:_______________________________________
4. Director of Organization:_________________________________________________
Phone # :_______________________________________
5. Total Agency Budget:_______________________________________
Program Budget:________________________________________
Amount Requested:______________________________________
6. Project Title:__________________________________________________________
Project start date:___________________________________________________
7. Funding requested for an ongoing or new program for your organization? Yes____ No____
8. For entire organization:
Fund raising costs :__________________%
Administrative costs or other overhead______________ %
9.What percentage of our donated dollar is allocated for charitable cause:_______________%
10. Type of request:
____ General support ____ Start-up costs
____Specific Project support ____ Technical assistance
____ Endowment ____ Capital expenditures
____ Other ( please describe)
11. Principal sources of support:
_____% United Way _____% Government contracts
_____% Foundations/corporations _____% Earned income
_____% Individual contributions _____% Private Community
13. Previous funding from the Andrews Foundation? Yes ____ No ____
Date:_____________________
14. PURPOSE OF REQUEST (See attached guidelines)
15. LIST ANY OTHER ORGANIZATIONS IN THE AREA WITH A PURPOSE SIMILAR TO YOUR ORGANIZATION AND DESCRIBE COLLABORATION, IF APPROPRIATE.
16. Please enclose the following information with this application:
-Current Board of Directors
-Current audited financial report.
-An applicant must have obtained a 501(c)(3) determination
letter prior to submitting an application and must include a
copy with this application.
Meeting with the Andrews Foundation
On occasion, the Andrews Foundation welcomes the opportunity to meet with potential grantees by making a site visit. We prefer, however, to postpone such meetings until after the grant application is reviewed in order to determine if the meeting will be fruitful.