Equity and Impact Funding Application for Emergency Funds

Equity and Impact Application for Communities of Color Emergency Funding

Organizational Information

Name of Organization Applying:(Required)

Service Area/Regions:(Required)

Please select the best that applies to your organization.

Service Population

Organization Contact

Email(Required)

Phone(Required)

Website

Funding Request

Please provide a description of the program and a brief description of goods for which you are seeking reimbursement.(Required)

Upload Receipts(Required)

Max. file size: 100 MB.

What program or project is the funding for, who does it serve, and what does success look like? (If needed, please attach a word document or pdf for longer narratives)(Required)

Optional File Upload

Max. file size: 100 MB.

How much funding are you requesting?(Required)

Budget

Food and Ingredients

Food Prep (Stipends for Volunteers, etc.)

Vouchers or Gift Cards

Supplies

Other

Total Request(Required)