Community Foundation of the Ozarks

Please fill out as many of the fields below which pertain to your organization and proposal.

Name of the Organization Applying:
Address 1:
Address 2:
City:
State:
Zip:
Phone:
Fax:
Contact Person:
Contact's Email:
Please Choose the Grant you are applying for:
SPRINGFIELD METRO GREENE COUNTY GRANTS (Applicable for Greene County Programs)
HEALTH AND SOCIAL SERVICES (DUE AUG. 31, 2007)
ARTS/CULTURE AND ENVIRONMENT (DUE OCT. 5, 2007)
EDUCATION AND COMMUNITY DEVELOPMENT (DUE FEB. 8, 2008)
COOVER GRANT (Applicable for Regional Programs)
COOVER CHARITABLE FOUNDATION GRANT (DUE JAN. 18, 2008)
Please provide the committee with a brief (3000 character max) description of the community need/problem for which you are requesting a grant:
Please provide the committee with a brief (4500 character max) description of the project’s primary goal and expectation of project impact:
Please provide the committee with a brief (3000 character max) description of project delivery, numbers served, and collaborative opportunities:
Please provide the committee with a brief (3000 character max) itemized total project budget inclusive of the Community Foundation request, as listed below. List only numerical amounts, excluding commas, decimals and dashes. For example, $3.00 would be listed as 3, $30.00 as 30 and $300.00 as 300.

	Project Itemized Expenses	Explanation (Optional)	External Funding	Agency Funding	CFO Requested Funding	Total Item Expense
1.			$	$	$	$
2.			$	$	$	$
3.			$	$	$	$
4.			$	$	$	$
5.			$	$	$	$
6.			$	$	$	$
7.			$	$	$	$
8.			$	$	$	$
9.			$	$	$	$
10.			$	$	$	$
Total:			$	$	$	$

Please provide the committee with an abbreviated (100 word max) project summary: