Clipper Petroleum

2023 Grant Application

Deadline: October 31, 2023

Date:

Organizational Information

Organization Name:

Address:

City:

State:

Zip:

Phone:

FAX:

EIN:

Organization's Website Address:

Key Contact Information

Name:

Title:

Phone:

Alt. Phone:

Email Address:

Details on the Organization

Describe the Organization's Mission:

Provide a brief history and summary of current activities of your organization:

Information on Project Seeking Funding

Project Title:

Project Description:

Information on Project Seeking Funding (continued)

Project Benefits:

Request Amount:

Project Budget (if greater than grant request):

How do you plan to raise the balance of the Budget?

Provide a detailed list of estimated costs for the project:

Project Start Date:

Project End Date:

Submitted by:

Title:

Date:

Upload following documents (Only pdf, doc(x), xls(x) and jpg are accepted).
Please be sure your file name uses only hyphen and underscore for punctuation, other characters including spaces will cause an upload error.

Copy of organization's tax exempt status under Section 501 (c) (3) of the IRS code or a verification of your organization's tax exempt status:

Detailed list of the estimated costs for the project:

Please provide the most recent financial statements for the organization (income statement and balance sheet):

Any additional information you would like to send:

Grant Application Checklist

Please make sure you have submitted the following:

A COMPLETED application that includes all requested information (incomplete applications will not be reviewed)
A copy of your organization's tax exempt status under Section 501 ( c ) (3) of the IRS code or a verification of your organization's tax exempt status
A detailed list of the estimated costs for the project.
Any other information you would like to send

2023 Grant Application Deadline: October 31, 2023