COMMUNITY GRANT APPLICATION

UKIAH NATURAL FOODS
NON-PROFIT COMMUNITY ORGANIZATION
GRANT APPLICATION

Organization _____________________________________________________________

Date: ____________________________________________________________________

Address:___________________________________________________________________

Phone:___________________________________________________________________

Name of Contact Person:_______________________________________________________

Title of Contact Person:________________________________________________________

Fiscal Agent (if using one):______________________________________________________
(Please attach copy of 501(c)3 letter of your organization or fiscal agent organization)

Project Title:_________________________________________________________________

Project Location:______________________________________________________________

What does your organization do and/or what services does it provide?

Amount Requested:_____________________ Total Project Cost:_______________________

Using a separate response sheet, please answer the following questions.

1. Please describe the project or activity for which you are requesting funding.

2. Outline your proposed project/activity budget. Specify revenues, by sources, as well as expenditure,
by type. (Note: No more than 10% of requested amount can be used for overhead costs.)

3. Describe the current sources of your organization’s funding.

4. Outline your project/activity timeline.

Please return this completed application by May 30, 2008, to:

Ukiah Natural Foods Co-op
Community Grants, ATTN: Jacquie Lee
721 S State St.
Ukiah CA 95482