Norris Foundation – Community Grant Application Form

Name of Organization*
Organization Tax ID Number*
Location Address*
Street Address Address Line 2 City State ZIP Code
- Mailing address same as location
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Executive Director*
Prefix First Last Title
Contact Person*
First Last
Telephone*
Email Address*
Website
Amount of Request*
Total Organization Budget*
Total Project Budget*
Project Name*
Project Period*
Description of Project.*
Target Demographic, Expected Number Served, and Expected Results.*
History and Goals of organization.*
List of other organizations contacted for support of this project and amount(s) requested.*