Apply for Grant Under $5000

Columbia Community Foundation P.O. Box 567 Columbia Station, Ohio 44028 Phone: 440-236-8000info@thecolumbiacommunityfoundation.org www.thecolumbiacommunityfoundation.org Registered 501(c3) Non-Profit Public Charity

Columbia Community Foundation Grant Application The following grant application must be completed in full and mailed to "Columbia Community Foundation; Attn: Grant Application; P.O. Box 567; Columbia Station, OH 44028" in order to be considered. All completed grant applications will be reviewed at the foundation's next board meeting following receipt. You may be asked to provide additional information. Please complete all sections of this grant application and please print clearly in ink.
Requesting Organization's Full Legal Name
Requesting Organization's Doing Business As (if applicable)
Requesting Organization's EIN or Tax ID Number
Is Requesting Organization a Registered Nonprofit?

Yes No
If "YES", then provide a copy of the IRS Letter of Determination)

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If Requesting Organization is a Registered Nonprofit, then what Type of Nonprofit:
501(c)
Requesting Organization's Address/City/State/Zip
Contact Person's Full Name
Contact Person's Title
Contact Person's Telephone Number (with Area Code)
Contact Person's FAX Number (with Area Code)
Contact Person's E Mail Address
example@example.com
Requested Amount of Grant (in USD)
Justification and Purpose for Grant Request (Attach if necessary)
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Contact Person's Signature

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Date

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