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Ergon Foundation Grant Application
Foundation Grant Application
Legal Information
Primary Contact Info
Organizational History
Grant Request
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I. Legal Organization Information:
*
Indicates required fields
Organization Legal Name
*
Organization Name, or AKA if different
Tax ID / EIN
If your organization is not required to have a Federal TIN, please provide a brief explanation below:
This will not influence the decision regarding your application.
Website address:
*Total Annual Operating Budget (current FY)
*
$
Total Number of:
Board Members
*
FT Staff
*
PT Staff
*
Next: Primary Contact Info
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