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Discretionary-Grant-Application
SSP Admin
2022-05-10T14:34:23-06:00
Grant Application I
Application for discretionary grants at the invitation of the Board of Directors.
Step
1
of
4
- Your Organization
0%
Organization Name
(Required)
Physical Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Mailing Address
(Required)
Same as physical address
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Website
Primary Contact
Name
(Required)
Title
(Required)
Phone
(Required)
Email
(Required)
Executive Director
Name
(Required)
Title
If different than
Executive Director
FEIN
(Required)
An FEIN is a Federal Employer Identification Number or Federal Tax ID for your business.
Date of incorporation
(Required)
MM slash DD slash YYYY
Is your organization tax exempt under Section 501(c)3?
(Required)
Yes
No
Please upload your IRS Determination Letter
(Required)
Accepted file types: pdf, Max. file size: 24 MB.
Please upload a copy of your most recent 990.
(Required)
Accepted file types: pdf, Max. file size: 24 MB.
Please upload a Certificate of Good Standing
(Required)
from your state's Office of the Secretary of State.
Accepted file types: pdf, Max. file size: 24 MB.
All non-profits awarded a grant by The Simon Charitable Foundation must be in Good Standing with the Secretary of State's Office. If your non-profit was organized in New Mexico, you can learn more at the
Office of the New Mexico Secretary of State
. If your non-profit was organized in another state, please ensure that your filings are up-to-date with your state's Office of the Secretary of State.
New Mexico Charitable Registry
(Required)
My organization is registered with the New Mexico Attorney General's Registry of Charitable Organizations and our registration is up-to-date.
All organizations awarded a grant by The Simon Charitable Foundation must be a registered non-profit with the New Mexico State Attorney General's Office. This includes non-profits organized both in New Mexico and in other states.
Learn more at
Charity Registration FAQs
.
Fiscal Sponsor
Because the IRS has not yet determined your status under Section 501(c)3, you will need to have a fiscal sponsor or fiscal agent in order to receive a grant from The Simon Charitable Foundation. Please complete the information below. Grant awards will be made to your fiscal sponsor.
Organization
(Required)
Contact Name
(Required)
Contact Title
(Required)
Mailing Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
Email
Project or Event Title
(Required)
Amount Requested
(Required)
Please enter a number less than or equal to
5001
.
Project or Event Description
(Required)
Please provide a brief description of the project/event.
Project Beneficiaries
(Required)
Who will directly benefit from the project/event? What is the primary population group served by your project or event?
Authorized Representative
(Required)
Please type your name
Signature
(Required)
Date Signed
(Required)
MM slash DD slash YYYY
Comments
This field is for validation purposes and should be left unchanged.
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