Sbm FoundationLinerant

SBM Charitable Foundation - Online Grant Pre-Application

The SBM Charitable Foundation is committed to bettering the lives of those who live and work predominantly East of the River, in Hartford, Tolland, and Windham Counties. Priorities for funding include health, human services, education, housing and the arts.

The purpose of this form is to gather information, specific to your grant request, that will aid the Foundation in deciding whether a full application will be considered for funding. There are several criteria that must be completed to receive consideration. Please fill in the data appropriate to your organization, using the form below, and hit "Submit" when completed. You will receive an email confirmation within a few minutes of submission, and a representative from the Foundation will contact you following review of your initial request.

Thank you for using the SBM Charitable Foundation Online Grant Pre-Application.

*Please note - do not input any dash (-), percent (%) or dollar ($) signs in the fields below. Your form will not be processed if you do.


Organization Name

Street Address

City

State

Zip Code

Contact Number (Digits only - no dashes or parentheses - enter as "8605551212")

Name of individual submitting this form

Title of individual submitting this form

Email address of individual submitting this form

Please identify what type of service your organization provides from the list

Please select what region of Connecticut your organization primarily serves

Please select what Connecticut towns your organization primarily serves (use Ctrl-key to select multiple)

Direct Number of your Executive Director/CEO

Amount Requested (Digits only - please omit "$" sign)

Total Project Budget (Digits only - please omit "$" sign)

% Administrative Cost Ratio (Enter "unknown" if you do not know this)
                                                 (Digits only - please omit "%" sign)

501(c)(3) ID. Your 501 (c) (3) ID is your organization’s tax identification number not your telephone number. (Digits only - please omit "-" sign)

Approval of Chief Executive Officer:
The organization named above will act as the responsible fiscal agent for any funds which might be received and will comply with applicable tax laws, regulations, and the SBM Charitable Foundation, Inc.’s policies.  We understand that SBM Charitable Foundation, Inc. requires periodic program and financial expenditures reports from grant recipients and may request the opportunity to visit our programs before awarding a grant, or after a grant has been made, for purposes of project evaluation..

Signature (type as follows: /First Name Last Name/)

Title