Preliminary Application - Hirschfeld Family Foundation

Grant Application

Complete the 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)

First Last

Contact Person Phone Number(Required)

Contact Person Email(Required)

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

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

Specifically, what does your organization do?(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 audited financial statements?(Required)

Yes

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

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

Yes

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)

Projected Total Cost of Project:(Required)

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