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Esperanza Hispanic Ministry Small Grant Fund
1.
Name of Organization
2.
Name of Partner Organization
3.
Name of Partner Organization (2)
4.
Address
5.
Address (2)
6.
Contact Person & Title
7.
Email
8.
Address
9.
Phone
10.
Website
11.
Phone
12.
Type of Request from Esperanza
13.
Total Funding Request Amount
14.
Previous Esperanza Funding
Yes
No
15.
Does this grant serve the Philadelphia County?
Yes
No
16.
Client population served by grant request
17.
Total annual organization budget
18.
Provide a brief summary of your organization’s history & mission (300 characters)
19.
Additional writing space.
20.
Provide a brief summary of Grant Request including the challenge(s) you hope to address (500 Characters)
21.
Additional writing space.
22.
What positive change do you expect to result from your program or project? (500 Characters)
23.
Additional writing space.
Identify no less than three (3) church leaders that you would engage in your program or project.
24.
Church Leader #1
25.
Phone
26.
Email
27.
Church Leader # 2
28.
Phone
29.
Email
30.
Church Leader #3
31.
Phone
32.
Email
Please list three (3) references and their contact information.
33.
Reference #1
34.
Phone
35.
Email
36.
Reference #2
37.
Phone
38.
Email
39.
Reference #3
40.
Phone
41.
Email
42.
How will you evaluate your project (300 characters)
43.
Additional writing space.
44.
Please submit your Organizational Budget.
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45.
Please submit your Program Budget
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46.
Please submit your List of Board of Directors.
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