2017-2018  Community Grants Request Form 

This form must be completed and mailed to the Spouses’ Club of Fort Eustis Community Grants Committee Chair with a postmark no later than April 9, 2018 for grant distributions in May 2018.

Please send completed applications to the address provided above.  Only completed applications will be considered.  Please use the back for any additional comments.

Name of Organization: _________________________________________________________________

Point of Contact: ______________________________________________________________________

POC Address: ________________________________________________________________________ POC Telephone: _________________________Email: _______________________________________

Website, if applicable: __________________________________________________________________

Funds will be payable to: _______________________________________________________________

 

  1. Date of Application_____________________    Amount Requested_______________________

 

  1. What or how does your organization contribute to the area’s military community?

_____________________________________________________________________________

 

  1. How many service members and/or family members benefit from your service/organization?

_________________________________________ What is the overall size of your organization

(if applicable, i.e. Scouts, choir, etc.)? ______________________________________________

 

  1. Where is the organization located? _________________________________________________

 

  1. What specifically will the funds be used for?

_____________________________________________________________________________

 

_____________________________________________________________________________

 

Use back of form for additional space.       Are you able to document the funds use? __________  

 

  1. Does your organization have other means of support? ___________  List sources ____________________________________________________________________________

 

Signature: ____________________________________________________           

         

BY SIGNING THIS APPLICATION, I UNDERSTAND THAT THE MONEY WE MAY RECEIVE WILL BE USES FOR THE PURPOSE AS NOTED ON THIS REQUEST