2024 Grant Application Form

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Before printing your application please make sure you have expanded all text boxes to ensure the Board can fully read your application.
I have read and acknowledge all guidelines for this application process *
Areas of Charitable Service (check all that apply): *
 
Region served by Organization (check all that apply) *
 
May the Foundation contact the accounting firm for additional information? *

Type Of Grant Requested

Project Description

Project Plan

Evaluation Process

Budget Information

Budget Detail (These are example templates. Please provide your actual Project Budget and Organization Budget as one of the required attachments.)
 Budget For ProjectAnnual Budget for Organization
Salaries
Payroll Taxes
Fringe Benefits
General Overhead
Travel
Consultants / Professional Fees
Postage
Office Supplies
Marketing / Communications
Capital Expenditures
Revenue Detail
 Budget For ProjectAnnual Budget for Organization
Individual Contributions
Corporate Contributions
Foundation Grants
Government Grants
Membership Income
Special Events
In-Kind Support
Other (specify)
Office Supplies
List all other foundations that have been asked to fund this project, the amounts requested, and the current status.
 Amount RequestedStatus
Foundation
Foundation
Foundation
Foundation

Attachments Required - Please print and include in your mailed-in application.

Statement from Applicant Organization’s Chief Executive Office and Chief Volunteer Officer:
 
We do herby certify that the information provided in this Grant Application is accurate and complete to the best of our ability and knowledge. We further acknowledge that if awarded a grant from the Carrico Family Foundation, we will provide certification to the Carrico Family Foundation that the funds have been used for the purposes for which the grant was awarded. We will make this certification within the time specified by the Grant Agreement.
Chief Executive Officer of Applicant Signature
clear
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Chief Volunteer Officer of Applicant Signature
clear
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We do not accept electronic application submissions. After submitting this form you will receive an email of your completed answers. Please print that email and supporting documents and mail to:

 
Carrico Family Foundation
PO Box 4436
Medford, OR 97501
Before printing your application please make sure you have expanded all text boxes to ensure the Board can fully read your application.