To Apply for a Grant, please fill out the application belowPlease refer to the Grant Requirements Document.Legal Entity Name (DBA)(Required) Tax ID or Employee Identification Number (EIN)(Required) Are you a Registered IRS 501c3(Required) Yes No Name(Required) First Last Title Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone(Required)Email(Required) Project or Event Name(Required) Start Date MM slash DD slash YYYY End Date MM slash DD slash YYYY Grant Request Amount(Required)$250$500$750$1000Provide a list of your Board of Directors and Officers(Required) Are there any compensated/uncompensated members of the Mukilteo Kiwanis Foundation or Kiwanis Club of America involved within your organization?(Required) Yes No Please list their names and any compensation received Describe your organization's mission and goals(Required)Describe your organization's current funding sources (provide relevant financial disclosures)(Required)Does your organization directly benefit children located in Snohomish County?(Required) Yes No Provide a description of the services you provide to the children located in Snohomish County(Required)How many children will benefit from this grant?(Required)Please provide whole numbers, for example, 0, 2, 100, etc. Do not include special characters or words.What are three (3) measurable outcomes you expect to achieve due to receiving this award(Required)Do you agree to submit a final written reports within six months of receiving the grant detailing how the funds were used and how many children were impacted?(Required) Yes No Signature (attesting the information submitted is complete, truthful and contains no misrepresentation)(Required)
