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Saemann Foundation Grant Form
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* Indicates required question
Organization name
*
Your answer
Organization mailing address
*
Your answer
Phone
*
Your answer
Organization Email address
*
Your answer
Organization website
*
Your answer
Contact Person and title
*
Your answer
Is your organization based in Kosciusko County, IN?
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Yes
No
Organization's Mission/General Function
*
Your answer
Amount of grant request
Your answer
Classification of organization
*
College
Library
Hospital
Volunteer Program
Other
Please provide a brief description of the purpose of the request, or how the funds will be used.
*
Your answer
How much is your annual budget? (For example, $325,000)
*
Your answer
Please list major donors
*
Your answer
Current Board members
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Your answer
Does your organization have 501 c 3 status?
*
Yes
No
If your organization is not a 501 c 3, please explain.
Your answer
Have you previously received grant monies from the Saemann Foundation?
*
Yes
No
If you have previously received grants from the Saemann Foundation, please list the years and amounts.
Your answer
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