Grant Application

First Name:*

Last Name:*

Middle Initial:*

School Title:*

Direct Phone No.:*

Project Title:*

School Name:*

School Phone No.:*

School Email:*

School Address:*

City:*

State:*

Zip:*

Amount of Funds you would like to request:*

Date the Funds will be Needed (Year and semester):*

Other Grants:
If you have applied for any other grants please tell us in the box below. Include the amount(s) you requested and current status of your request(s).


Project Description:
Detail goals and objectives for the specified program including target audience (not to exceed 500 words).


Project Timeline:
Please indicate your project activites and the planned date of completion of each activity in the box below.


Project Evaluation:
Indicate how your organization will evaluate the program/project if funded.


Project Budget:
Please detail the break-down of expenses.


Applicant's Information Release Statement:
I authorize the release of the following information for review by all members of the Board of Directors for Impossible Possibilities: Completed Grant Application, Project Description, Project Timeline, Project Evaluation and Project Budget. I hereby certify that the information submitted is true and correct to the best of my knowledge. I understand that all submitted proposals will become the property of Impossible Possibilities. I understand that Impossible Possibilities reserves the right to feature any selected program in a story on the organization?s website. I understand that by checking the box below and initialing I have read and agree to the Grant Initiative Rules and Regulations.

Initials:*

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