CITYKIDS GRANT FORM

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Organization Name

Address

Project Name - (What is the name of the particular project for which the grant is being requested? If the grant, instead, would fund general operating expenses, please so indicate.)

Geographic Area - (What specific geographic area(s) will the program serve?

Annual Budget - (Please enter the most recently completed fiscal year and the organization’s total expenditures for that year.

Number of Employees - (Please enter the number of employees.)

Mission Statement - (What is the organization’s mission statement?)

Summary - (Please summarize what the grant funding would support by finishing the sentence:)

Project Manager - (What are the name, title, and qualifications of the manager of the project for which funds are being requested.)

Buget Form - (Please provide a estimated project budget, including plans for the expenditure of grant funds from Maiya Inc.

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Board Compensation - (Please list all amounts paid by the organization to any board members.)

Board Members - (Please list all active board members.)

501(c)(3) Verifcation Form

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Initials

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

CITY KIDS

BUILDING OUR COMMUNITY

CITY KIDS

BUILDING OUR COMMUNITY

CITYKIDS GRANT FORM

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