Grant Application

Please fill out all the required fields. Otherwise, you would not be able to submit the form.



Contact Information
 Full Legal Organization Name:  
 Street Address:  
 City:
    State:     Zip Code:  
Organization Website:  

Organization President /
Executive Director:
 
Title:  
 PHone Number:
    Email:  

Contact Person:  
Title:  
 PHone Number:
    Email:  
 
Organization Information
 501(c)(3)?:

  Year Established:  
Fiscal Sponsor Name:  
Fiscal Sponsor Address:  

 Total Organization Budget:
    Total # Board Members:  
 Total # of Staff:
    Total # of Volunteers:  

Organizational Mission
Statements
:
 
Brief Description of
Organization:
 
Brief Description of Services
Provided:
 
 
Grant Request
Program / Project Name:  
Total Program Budget:  
Requested Amount:  
Percent of Total Budget:  

Type of Request:  
   
One-Time Request?:

Purpose of Requested Funds:  
City Priority Funding:  
Impacts on Cupertino
Community:
 
Staff Competency::  
At Least 75% of Funding Will
Go Toward Direct Service?:

Usage of Prior Year's Funds:  
Requests Made to Other
Agencies:
 








Note: Please fill out all the required fields. Otherwise, you would not be able to submit the form.