Grant Application - Hirschfeld Family Foundation

APPLICANTS FOR THE HIRSCHFELD FAMILY FOUNDATION GRANTS

Please fill out this Grant Application Form in its entirety and include the requested attachments as a single PDF.

The Hirschfeld Family Foundation has been qualified by the Internal Revenue Service as a charitable foundation. The Articles of Incorporation for the Foundation provided that all bequests must be made to a non-profit qualifying under Section 501(c)(3) of the Internal Revenue Code.

All Grant Applications received shall be considered by the Board of Directors of the Hirschfeld Family Foundation.

Should you have any questions concerning the Grant Application Form or the procedure for submission of the Grant Application Form, please contact: Christie.heacock@hvrtrust.com

Applicant Information

Name of organization:(Required)

Date of application:

Contact person:(Required)

Prefix

First

Last

Title:(Required)

Phone:(Required)

Email:(Required)

Enter Email

Confirm Email

Address:(Required)

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Federal I.D. number:(Required)

Nature of Organization

Date of incorporation:(Required)

Place of incorporation:(Required)

Date of IRS determination as to Charitable Tax Exempt Organization:(Required)

What is the mission of your organization?(Required)

Specifically, what does your organization do?(Required)

Accomplishments of the organization:

Number of staff and volunteers of the organization:

GRANT PURPOSE

Total amount requested from all sources:(Required)

Amount requested from the Hirschfeld Family Foundation:(Required)

When are funds required?(Required)

Grant purpose:

Expected results from grant funding:

Plans and timeline for implementation:

Who is responsible for the implementation?

Have you previously requested a grant from the Hirschfeld Family Foundation?(Required)

Yes

Determination:(Required)

If yes, when?(Required)

If you received a previous grant(s), what was the outcome?(Required)

Please attach the following information:(Required)

1. Latest audited Financial Statements; to include Balance Sheets and Income
Statements (and an explanation if the audited Financials are not available) and
also include a copy of your most recent Form 990 filed with the IRS; and

2. A copy of the IRS letter acknowledging exempt status.

3. List of Board of Directors, Officers & Executive Management including addresses

Attach as one single PDF

Accepted file types: pdf, Max. file size: 50 MB.

Grants are given to organizations that are tax exempt under Section 501(c)(3) of the Internal
Revenue Code or government entities. Grants will only be approved for foreign entities that
meet specific charitable status requirements.

The Hirschfeld Family Foundation may fund multiple year projects, but rarely for a period of
more than three (3) years. All grants approved for more than one (1) year are conditional and
are subject to annual review and approval before subsequent funds are released.