Nomination Form

The many ways in which our LOOPers engage with their communities inspire us nonstop. That's why we're going to donate $1000 to at least five nonprofit organizations that you – our amazing LOOPer tribe – nominate!  
 
Nominations close November 12th, 2021 at 11:59pm PST.
 
Grant Eligibility RequirementsSuccessful nominated organizations will be nonprofit 501(c)(3)’s in good standing that:
Are an important part of how you - our amazing LOOPer! – gives back
Make a meaningful impact locally
Can do meaningful work with this Grant funding

Grants are not made:
To organizations that discriminate against certain groups or individuals in the delivery of programs and services on the basis of race, religion, national origin, gender, age, sexual orientation, or disability
To religious organizations, unless the organization has a secular purpose, no religious content, and benefits the greater community without regard to religious affiliation
For elections, political candidates, or political campaigns
For social or political issues outside the United States
To individuals
For temporary exhibits, travel, surveys, films, or publishing activities
For endowment funds
For fundraising dinners or events
To organizations based outside of the US or Canada
Your Information

Question Title

* 1. What is your name?

Question Title

* 2. Where are you from? (City, State)

Question Title

* 3. What is your email?

Nominee Organization Details

Question Title

* 4. Organization Name (Note: The organization must be a registered 501(c)(3) to be considered)

Question Title

* 5. Organization Website

Question Title

* 6. Which city is the organization based in?

Question Title

* 7. Tell us about your experience with this organization and how you have LOOPed in with them. (Max. 150 words)

Question Title

* 8. Why is this organization an important resource in your community? (Max. 100 words)

Question Title

* 9. Any other comments?

Question Title

* 10. Any pictures of you engaging with the organization you'd like to share?

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

Question Title

* 11. Are you willing to be contacted for a feature on LA LOOP's social media channels?

Thank you for your nomination!

T