Application for Financial Assistance
Please complete this application form and submit online. Additional requested supporting documents may be emailed to outreach@graceepiscopallexington.org or mailed(or brought) to the church office at the address below. Application deadline is March 11, 2019.
Email address *
Grace Episcopal Christian Outreach Committee
123 W. Washington Street
Lexington, VA. 24450
540.463.4981
Date of Application: *
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Amount Requested: *
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1. Name of Organization: *
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2. Address: *
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3. Director or principal contact : *
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Name and Title: *
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Email: *
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Telephone number: *
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4. Organization’s mission (purpose statement). *
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5. Approximately how many individuals were served by your organization in 2018? *
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6. What were your funding sources in 2018? *
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7. To what funding sources have you applied for 2019? *
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8. Please email or mail a summary statement of your organization’s income and expenses for 2018 to outreach@graceepiscopallexington.org or mail to the address above.
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9. Please tell us how this grant money, if awarded, will be used. If for a specific project, please provide a breakdown of estimated costs.
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10. Did you receive a grant from Grace Episcopal Church last year? If yes, please tell us how the funds were used.
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11. Are you a 501 (c) (3) organization? If yes, please provide your letter of tax-exempt status by email to outreach@graceepiscopallexington.org or mail to the address above.
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12. In addition to funding, do you need any hands-on volunteers? If yes, please specify
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13. How did you hear of the Grace Episcopal Church Christian Outreach Committee?
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Signature
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Position within organization
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