GRANT FORM | TRLA

GRANT REQUEST FORM

In order to complete the grant request form, an individual must meet the following requirements:

Only a member of the TRLA in good standing may submit a grant request.
The member proposing the request must be actively involved (please describe) with the proposed recipient and with the work or project being proposed.
This grant application must be completed in full and submitted by a member of TRLA in good standing.
Grant requests must be received by November 1, 2024

Organization

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Phone

Is your orgnizatin a 501c3?

Yes

If your organization is a 501c3, please enter your FEIN

What is your organization's mission?

Contact Person's Name:

Phone

Amount Requested:

Does this amount reflect the entire cost for this program/project?

Additional Funding and Source(s), if any:

Description of purpose for the request, statement of impact:

Please describe your involvement/role with the organization and with the project:

Are at least 75% of the beneficiaries of this grant over the age of 65?

Thanks for submitting!