Grant Application – The William Stretesky Foundation

"*" indicates required fields

Note: You will receive a copy of your application via e-mail once you submit this form; please be sure you enter your e-mail and other contact information accurately! Fields with asterisks are required.

Name of Organization*

Address*

Street Address Address Line 2 City State ZIP Code

Contact Person*

First Last

Title

Phone*

Website

Federal Tax Id

Attach List of Governing Board, Including Names, Addresses, and Titles

Accepted file types: pdf, doc, docx, xls, xlsx, Max. file size: 32 MB.

PART 1 - INFORMATION ABOUT THE APPLICANT

Is the applicant currently a 501(c)(3) nonprofit organization recognized by the Internal Revenue Service?

Yes

Attach a copy of the IRS exemption letter. (Do NOT attach a copy of your sales tax exemption.)

Accepted file types: pdf, doc, docx, xls, xlsx, Max. file size: 32 MB.

Explain why applicant could still qualify for funding from this Foundation.

Brief Organizational Overview: (include mission statement)*

Have funds been requested/funded from other sources for this project?*

Yes

If funds have been requested/funded from other sources for this project, please furnish the following:

Accepted file types: pdf, doc, docx, xls, xlsx, Max. file size: 32 MB.

Amount(s) previously requested
Source of request
Date of request
Date & Amount Received

Has the organization previously received funds from The William Stretesky Foundation?*

Yes

Please specify amount(s) and years(s) received.

Part 2 - Grant Request

Total Amount of Project*

Please do not include $ - just enter a number

Total Amount Requested From Stretesky Foundation*

Please do not include $ - just enter a number

Organization's Contribution Towards Project (i.e. cash, time, services, etc)*

Provide a description of the grant request including the projected immediate outcome:*

If this request/project is ongoing, please share the organization’s future financial security plan:

Explain how this request/project enhances our community and the impact it will make on Sedgwick County residents:*

Is there any other pertinent information you would like to share with the Foundation Board?

Please attach your organization’s supporting documents including: most recent financial statement; current year’s budget: multiple estimates for project; and pictures, if applicable. If any of the above is not available, attach a statement of explanation.*

Drop files here or

Accepted file types: pdf, doc, docx, xls, xlsx, Max. file size: 32 MB, Max. files: 12.

Authorized Agent’s Signature and Title*