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Commission’s Grant Application Form

  1. Shelby County Board of Commissioners

    GRANT APPLICATION

  2. PLEASE BE ADVISED THAT ORGANIZATIONS MUST BE ABLE TO PROVIDE AT LEAST 12 MONTHS OF FINANCIAL HISTORY.

  3. IF YOU ARE OPERATING UNDER THE UMBRELLA OF ANOTHER ORGANIZATION OR BEING REPRESENTED BY ANOTHER ORGANIZATION, THEY MUST BE THE ONE TO APPLY FOR THE GRANT.

  4. PLEASE PROVIDE A ZIP CODE AND CLICK here TO FIND OUT THE DISTRICT (COUNTY COMMISSION) OF YOUR ORGANIZATION.

  5. PLEASE ENSURE THAT YOU ARE PROVIDING GOOD CONTACT INFORMATION. ALL CORRESPONDENCE ABOUT GRANT REQUIREMENTS WILL BE SENT VIA EMAIL.

  6. EXECUTIVE DIRECTOR

  7. GENERAL CONTACT FOR THIS REQUEST(if other than Executive Director)

  8. DESCRIPTION OF GRANT REQUEST

  9. Requests $25k and over requires a most recent audit

  10. INTRODUCTION AND BACKGROUND OF ORGANIZATION

  11. Narrative - Organization

  12. Narrative - Funding Request

  13. General Operating Suport

  14. Project Support

  15. Attachments:

  16. If your request is under $25,000 please attach the following:

  17. 1. Copy of the entity’s 501 (c) 3 certificate for charitable organizations or 501 (c) 4 certificate for civic organizations

  18. 2. State Annual Reporting form for Nonprofit Organizations or a Copy of an annual audit as of a date within 18 months of the start of the current fiscal year.

    Please download and fill out the State Annual Reporting Form in PDF and then upload it below.

  19. 3. Complete Budget for grant request

  20. If your request is $25,000 or more please attach the following:

  21. 1. Copy of the entity’s 501 (c) 3 certificate for charitable organizations or 501 (c) 4 certificate for civic organizations

  22. 2. Copy of an annual audit as of a date within 18 months of the start of the current fiscal year.

  23. 3. Complete Budget for grant request

  24. ACKNOWLEDGEMENT:

  25. Read, and if you agree to the provisions, sign the following:

  26. The information provided has been submitted in good faith and as completely as our records and recollections permit.

  27. I understand that the information provided in this application shall be open to inspection upon filing with the office of the Shelby County Board of Commissioners.

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