Carbon County Community Foundation 2020 Grant Application Form
Application instructions:

The application is a single-screen, online form. You cannot save and revisit your application; you must complete and submit your application in one sitting.

Please note there are character limits for open text fields.

So that you have a copy of all content for your records, it is recommended that you preview the information you will need to supply, prepare your responses in a word processor program (such as Microsoft Word or Google Docs), and revisit the online form once you have all of your information ready.

Notification letters will go out in early May 2020; grant awards will be made later that month.

Contact the Foundation at 1-855-545-1311 or director@cccfoundpa.org if you have any questions or concerns.

Email address *
Applicant's first name *
Your answer
Applicant's last name *
Your answer
Job title
Your answer
Applicant phone # *
Your answer
Organization name *
Your answer
Website
Your answer
Mailing address - first line/street *
Your answer
City *
Your answer
State *
Zip code *
Your answer
Organization phone # *
Your answer
Organization mission statement *
Your answer
Year founded
Your answer
Is this a 501(c)3 nonprofit organization? *
Organization EIN# *
Your answer
Which area of community interest best describes your project/program? *
Title of program/project *
(75 character max)
Your answer
One sentence summary of the purpose of program/project *
(175 character max)
Your answer
Program/Project timeline *
List what will happen and when (300 character max)
Your answer
Please provide a detailed summary of the program/project or other purpose of your application: *
In a short narrative, summarize your organization's work and the project/program for which you are requesting funds. Describe the need and if possible, reference data, studies, or plans that document the need for the project/program. Describe the target population and the impact the program will have on the target population. (2500 character max)
Your answer
Estimated # of people served *
(300 character max)
Your answer
Current organization operating budget *
This is a single figure, the total revenue required to operate your organization annually. (25 character max)
Your answer
Total cost of program/project *
(25 character max)
Your answer
Requested amount *
(25 character max)
Your answer
Amount secured from other source(s) *
(25 character max)
Your answer
Please illustrate a budget for this program/project (may be emailed separately to director@cccfoundpa.org) *
Your answer
If partially funded by CCCF, will you be able to secure additional funds to go forward with the program/project within one year from award? *
Please list your board of directors and CEO/ED. Include names, positions, affiliations if appropriate. *
(1000 max character count)
Your answer
Other comments:
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