2022 MPF Grantee Application

Mt. Pleasant Fund Initial Application for Funding

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* 1. The name of your organization:

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* 2. Is yours an IRS recognized charitable organization?

Yes

No, but we have a fiscal sponsor that is a recognized charity

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* 3. The individual with whom we should be communicating with regard to your application:

Name

Title

Email Address

Phone Number

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* 4. The primary location of your organization

Address

City/Town

State/Province

ZIP/Postal Code

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* 5. Your mailing address (if different from your physical address)

Address

City/Town

State/Province

ZIP/Postal Code

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* 6. Do you operate from any additional locations? If so, where are they located?

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* 7. Has your organization applied to us for funding in the last five years? If yes, you may skip to Question #12

Yes

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* 8. How old is your organization?

More than 25 years

15-25 Years

5-15 years

0-5 years

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* 9. Please, in less than 100 words, describe the population that directly receives your services:

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* 10. Please, in 100 words or less, describe the program services that your organization provides:

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* 11. If your organization has a website, please write the address here:

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* 12. Your organization's most recently reported annual income:

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* 13. The percentage of your most recently reported income that came from:

Government Grants

Foundation Grants

Individual Donations

Other Sources