2019 ABB Cares Grant Application
NOMINATOR'S INFORMATION
Practice Name: *
Your answer
Contact Name: *
Your answer
Phone Number: *
(xxx-xxx-xxxx)
Your answer
Email Address: *
Your answer
Street Address: *
Your answer
City, State & Zip: *
Your answer
NOMINEE'S INFORMATION
*This information will be used only to notify grant recipients.
Name of Charity: *
Your answer
Contact Name: *
Your answer
Phone Number: *
(xxx-xxx-xxxx)
Your answer
Email Address: *
Your answer
Street Address: *
Your answer
City, State & Zip: *
Your answer
Distance from primary office of practice to local office of charity: ____ miles *
Your answer
1. Executive Summary: Describe the non-profit organization, its mission and its programming. *
500 words or less
Your answer
2. Reason for Nominating: Explain why you are nominating this organization and your personal connection to it. *
500 words or less
Your answer
3. Community Impact: Describe the organization’s impact on the community. Include quantitative data such as number of people served and programming outcomes or use illustrative examples and anecdotes to describe the charity's impact on quality of life. *
500 words or less
Your answer
4. Grant Impact: How will this grant be utilized by the organization? Describe specifically what the grant will fund. *
500 words or less
Your answer
SUPPORTING INFORMATION
If available, please supply up to three supporting documents such as photos, testimonials, letters of recommendation, annual reports, brochures, fundraising kits, newspaper articles or press releases. No websites or video will be accepted. (Limit 3) These will need to be emailed to: ABBCares@abboptical.com. Please be sure that the nominee's information is in the subject line of the email.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service