Grant Inquiry: Under $5,000 Please complete this form in its entirety. Incomplete applications will be discarded. Please do not apply for a grant more than once in a ten month period. Purpose of Grant Request Serving orphans domestically (USA) Serving orphans internationally Serving widows Serving children in foster care domestically (USA) Serving disadvantaged, at-risk children & families domestically (USA) Serving disadvantaged, at-risk children & families internationally Promoting entrepreneurship opportunities & Leadership skills domestically Promoting entrepreneurship opportunities & leadership skills internationally Homeschool legislation or initiative (USA only) Serving Palm Beach County, Florida Check all that apply.Organization and Contact InformationOrganization NameTax ID/EINAddress Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Website SalutationMr., Mrs., Dr., Rev., etc.Name First Last TitlePhoneFAXEmail Address Project InformationAmount of RequestPlease enter a value between 1 and 5000.Proposed TitleBrief description of the issue or problem you plan to addressWhat is distinctive about your approach?Explain why you are well-suited to undertake this workHow will you determine the results of this effort? In your view, what would constitute a success?Additional InformationIs this the first time you have applied for a grant from the Weisberg Family Foundation? Yes No Have you ever received a grant from the Weisberg Family Foundation? Yes No When did you receive your last grant? MM DD YYYY Amount of Last GrantAdditional File UploadsDocumentation of your 501(c)(3) statusProject DetailsFinancials
