Registration Form

THE PLAYERS GRANT APPLICATION

Please CLICK HERE and review THE PLAYERS Charity Guidelines before completing this application to ensure your organization qualifies.

Please be prepared to complete the form in it's entirety and click 'Submit' when you are done, as you will not be able to save or submit a partial entry.

Organization Name

EIN

Mailing Address

City

State

Zip Code

Phone Number

Email

Website

Contact Name

Title

Mission Statement

Project Name

The minimum grant request amount is $25,000 Requested Grant Amount

$

Total Annual Budget

$

Request Grant Type

Primary Focus Area

Project Summary

This section is limited to 1000 characters

DEMOGRAPHICS SERVED

Geographic Area(s) Served

Expected Numbers to be Served

Does the proposed program serve at least 51% of an underserved population? Population

Are the percentage of people served by the proposed program at least 51% Black/African American? Minority Reach

If the percentage served by the proposed program is less than 51% Black/African American, what underserved group(s) comprise at least 51% of the people served by the program: Demographic Composition

American Indian or Alaska Native
Asian
Hispanic, Latino, or Spanish
Native Hawaiian or Pacific Islander
White
Other (Please Specify Below)

Other Underserved / Underrepresented Groups

Groups / Areas of Focus

APPLICATION

Organization Name

Address

City

State

Zip Code

Website

Executive Name

Title

Email

Phone Number

501c(3)

Year Established

Total Operating Budget

# of Staff Members

# of Board of Directors

% of Directors Who Are Donors

# of Volunteers

Volunteer Hours per Year

NARRATIVE

Describe your organization, its services, and target population. Description of Organization

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Identify the challenge(s), opportunity(ies) or need(s) your proposal is seeking to solve. Area of Need

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Explain your proposed solution, and how it meets the identified needs and/or challenges. Proposed Solution

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List goals, objectives and evaluation metrics for your proposed project. Project Plan & Measures

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Have you previously received funding from THE PLAYERS?

Prior Funding Explanation

Total Prior Amount(s)

$

Date(s) Funding Received

Please advise how you will sustain funding and support beyond the grant award. Sustainment Plan

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Identify any partnerships or collaborations established to support/meet your identified need(s). Partnerships & Collaborations

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ADDITIONAL INFORMATION

In addition to providing the information in this form, please include with your request the following attachments. Failure to include the listed attchments will result in your application being declined and having to restart this process.

Proof of the organization’s 501(c)(3) status (designation letter/form)
Organization’s current fiscal year budget
Budget for the proposed project with narrative detailing planned expenditures
List of current Board of Directors
Annual report or related document, if applicable
Most recent IRS form 990
Two Letters of recommendation

To upload a file, Choose File, wait for file name to appear in line below, then select Upload File.The file name should then appear in the Uploaded Files list.

Upload Documentation

Uploaded Files:

I hereby certify that the aforementioned and enclosed information is complete and accurate and that the organization is in full compliance with all applicable laws, statues, ordinances, rules and regulations of any applicable governmental authority, including laws prohibiting support of terrorism.

Submitter Signature

Date

(*) indicates required field

Status:

Date of Decision: