Grant Application

The Cornwall Foundation
Grant Application
Date and Time
- Month - Day at Year / Hour Minutes
Legal Name of Organization*

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number*
- Area Code Phone Number
Fax Number
- Area Code Fax Number
E-mail*
Website Address
IRS 501(c) (3) Nonprofit*

Yes No
If No, identify your fiscal agent and include a copy of a written agreement from fiscal agent to sponsor the project.
Fiscal Agent
Contact Person and Title*
Executive Director (if different from Contact)
Organization's Mission*
Brief Summary of the Proposal*
Total annual organization budget:*
Fiscal Year End*
Month Day Year
Project Budget*
Amount Requested*
The period this grant will cover:
From*
Month Day Year
To*
Month Day Year
List any previous support from the Cornwall Foundation
What other steps have you taken to raise funds for this program? Please list other funding sources being sought for this program; include the name(s) of the organization(s) and the date of application.*
Describe the project/program for which grant monies are being requested and how the funds requested from the foundation will be used to support the project.*
The Cornwall Foundation aims to enhance life in Cornwall for all its residents. Describe how this project will contribute to that goal.*
Attachments
All of the following attachments must accompany the proposal.
1. IRS letter confirming tax-exempt status (501(c) (3) or 509(a)), or letter from fiscal agent.
Upload document here*
2. Current list of board members.
Upload document here*
3. Most recent independent audit or Form 990, if applicable.
Upload document here
4. Detailed project budget showing income and expenses.

Please include any other companies and foundations being approached to fund this proposal, with dollar amounts indicating which sources are committed, pending, or anticipated
Upload document here*
5. Current organizational operating budget.
Upload document here*
6. Attach the Certificate of Non-Discrimination.

The Certificate of Non-Discrimination can be found on the Application Process page of our website. Please complete and attach.
Upload document here*
Should be Empty:

The Cornwall Foundation

Grant Application

If No, identify your fiscal agent and include a copy of a written agreement from fiscal agent to sponsor the project.

The period this grant will cover:

Attachments

All of the following attachments must accompany the proposal.

1. IRS letter confirming tax-exempt status (501(c) (3) or 509(a)), or letter from fiscal agent.

2. Current list of board members.

3. Most recent independent audit or Form 990, if applicable.

4. Detailed project budget showing income and expenses.

5. Current organizational operating budget.

6. Attach the Certificate of Non-Discrimination.