Application in Legal
Application in Legal document sample
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Grant Application Organization Information Date of Application: Legal Name of Organization: Address: City: State: Zip: Telephone: Fax: Email: Executive Director Name: Telephone: Grant Contact Name: Telephone: Organization Description Provide 2-3 sentences regarding your organization, including a summary of mission and objectives: Age Group Served: (check all that apply) Babies/ Toddlers (under 5) Youth (5-18 yrs.) Young Adults (19-29 yrs). Adults only (30-60 yrs.) Aging/Elderly/Senior Citizens Focus Area Please check which Albertsons focus area your request falls under: Hunger Relief Health Nutrition Program Description Program Title: Amount Requested: $ Total Program Budget: $ Provide a brief summary of the program’s activities and why they are needed in your community. Please describe how the program will have a positive impact in the community. Volunteers Are there any opportunities for volunteer involvement in association with this grant/ project? If yes, please describe: Grant History In the past 12 months, have you received a grant from SUPERVALU or Albertsons? Yes No If yes, please list the grant date, program title, grant amount and brief program description for each grant received (in the past 12 months). Grant Date: Grant Amount: Program Title: Program Description: Please include the following documents with this application form: A completed W-9 An IRS copy of your organization’s 501(c)(3) letter if you are a nonprofit Any additional information that describes how the donation would benefit your organization (e.g., news clippings, no more than 2 sample photos, etc. Please do not provide videos/DVDs, event t-shirts, giveaways, etc.) Schools or units of government should submit your request on letterhead If located in Southern California or Southern If located in Idaho, Montana, Oregon, Utah, Nevada, please send your application to: Washington and Wyoming, please send your application to: Albertsons Communications and Public Affairs Albertsons Communications and Public Affairs Department, Department, 1421 S. Manhattan Blvd., 250 Park Center Drive Fullerton, CA 92831 Boise, ID 83726 Requests can take up to 6 weeks for review. If you are applying for an event, please send your request at least 8 weeks in advance of the event date.