Peoria Diamond Club
Grant Program - Application
Email address *
Name of Applicant (Organization) *
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Contact Name *
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Contact Title
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Phone number *
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Street Address *
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Amount Requested *
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Name to be printed on check if awarded grant: *
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Purpose of program, project, event, activity, etc.: *
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Estimated Project Start Date *
MM
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DD
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YYYY
Duration of Project: *
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Identified Target Population (who will benefit from this grant?): *
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Defined Service Area (school district, neighborhood, community, etc.) *Must be local to the Phoenix area* : *
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Describe the request as it relates to the PDC Grants Program guidelines: *
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Describe how the request will work. List key goals and objectives: *
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Identify other funding sources for this purpose, including individuals and organizations that contribute to the success of this request. Do not include in-kind contributors: *
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If requested, would you make a presentation to the Grants Committee or Executive Board about your organization and request? *
Has this organization ever applied for, or received funds from the Peoria Diamond Club? *
If yes, please include date(s), amount(s), and purpose(s) of previous request(s):
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Organizations/individuals receiving Peoria Diamond Club grant funds acknowledge that these funds are to be used solely in support of the purposes specified in the grant application. If program needs change, please contact the grants committee for approval. The organization receiving funds agrees to adhere to the Peoria Diamond Club's reporting requirements, including, but not limited to, submission of an expenditure report on the use of funds, and any requirements of the Internal Revenue Code pertaining to foundation grants. By submitting this form, you accept and agree to the above conditions of grant awards. *
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Submit your cover letter (email attachments to grants@peoriadiamondclub.org): *
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A copy of your responses will be emailed to the address you provided.
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