Preliminary Application - Hirschfeld Family Foundation

Grant Application

Complete this preliminary application form and the Hirschfeld Family Foundation (HFF) will review and respond within a few weeks. If the HFF is interested in exploring the grant request a full application will be requested. (Priority will be given to special projects rather than routine program support.)

Name of Organization(Required)

Contact Person(Required)

Prefix First Last

Contact Person Phone Number(Required)

Contact Person Email(Required)

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City State ZIP Code

What is the mission statement of the organization?(Required)

SEE BELOW FOR INSTRUCTIONS

Specifically, what does your organization do?(Required)

SEE BELOW FOR INSTRUCTIONS

Supplementary Information – (not required)

Date of IRS determination as to a charitable tax exempt organization:(Required)

Does the organization seek or receive government assistance?(Required)

Yes

Approximately what percent of the organization's activities are supported by such assistance?(Required)

Do you have financial statements audited by a Certified Public Accountant (CPA)?(Required)

Yes

What geographic area is served by the organization?(Required)

Has your organization previously submitted a proposal and/or grant application?(Required)

Yes

Determination:(Required)

Please provide the dates as well as the determination of each such submittal:(Required)

How much is being requested and for what specific purpose? Please include a project budget.(Required)

How much has been raised for the project to date?(Required)

Projected total cost:(Required)

Attach the most recent copy of your fiscal year end income statement and balance sheet as a single PDF file.(Required)

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

Please Read This Carefully

If you do not follow these instructions, your application will be returned without consideration.

Mission Statement

Your mission statement should be concise — no more than a sentence or two. This is an organization’s reason for being: the one basic concept that drives everything it does. To those who work with and for the organization and to those who receive services from it, the Mission Statement tells what the organization stands for. If you look at the Mission Statements of some of the most successful organizations you know, you will find that many have extremely short statements. This is not what you DO, it is what you ARE. (If your Mission Statement does not match our requirements, then write one that does.)

What You Do

Tell us succinctly the actual, physical things that you do either on a routine daily basis or for special activities and events. Use specific, concrete verbs that speak to observable actions, not words like “energize” or “empower” or “enable”. We want to be able to see you doing the things that you do. Four or five sentences should be sufficient.

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