Grant Application for
Simon test
Mission Statement:
fjadskldfjsalk
Fiscal agent if applicant is not tax exempt:
xxx
Tax ID Number:
Contact First Name:
Contact Last Name:
Denise
Simon
Address:
adsjklf
Email:
Phone Number:
231511111
Project Name:
test
Project start and end dates:
Amount Requested:
$
Project Description:
Goal of the Project
How many people will you reach?
What percentage are female?
If your program serves both males and females, how will Hestia funds specifically target women and girls?
How are recipients identified or selected to receive services? Is financial need considered?
What do you hope to achieve? What difference will this make in the lives of women and girls?
How will this project meet Hestia's mission statement?
How will you evaluate or measure your success:
Grant Project Budget Form
REVENUES
Revenue Item
A.
B.
C.
D.
E.
F.
G.
H.
I.
TOTAL REVENUES
Proposed Revenue
Pending or Confirmed
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
EXPENSES
Expense Item
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
TOTAL EXPENSES
Proposed Expense
$
$
$
$
$
$
$
$
$
$
$
$