Select Grant (Required)
Note: Changing the type of grant may delete information in the grant section of the form. We therefore recommend you decide which grant you’re applying for before proceeding past the General Organizational Information portion of this form.
General Organizational Information Contact Completing Application Name (Required)
Executive Director or Chief Officer Name (Required)
Organization Information Primary Address
(Required) Do you have a different mailing address? (Required) Select One… Yes No Mailing Address
(Required) Is your organization a non-profit (501c3)? (Required) Select One… Yes No Does your organization have a Fiscal Agent? (Required) Select One… Yes No List the names of Board Officers (with title) and all Board Members of your organization or Fiscal Agent. (Required)
Note: If you have a Fiscal Agent, list the names of the local Board or individuals responsible for the project.
Geographical Area Served: Check One (Required) List Cities/Areas Served (Required) Describe how you will acknowledge the Youth of Promise Fund and the support of the Antioch Community Foundation. (e.g., in program material, social media, press, event announcements, etc.) (Required) Is your organization able to provide ACF with photos, video testimonials, and/or other media from ACF supported events (Required) Select One… Yes No
Your organization will have an opportunity to approve any content used by ACF and contributing content is not a requirement to receive a grant.
Briefly state the mission/purpose of your organization and include a description of the populations you serve (Required) Program/Event Grant
The Program/Event Grant will provide funds of between $100 and $1,000 for community event sponsorships, program support, and organizational capacity building (such as, office technology, financial management or evaluation/assessment tools, and/or board or volunteer training, etc.) to nonprofit organizations serving one or more ACF grant priority areas.
Enter the amount you are requesting for this project (max $100 – $1000) (Required) Are other funders involved in the project? (Required) Select One Yes No List funders and confirmed and/or pending amounts. (Required) Briefly describe how these funds will support your effort in roughly 300 words or less. Include your overall purpose/goals; the ACF priority focus area you will serve (Youth Services, Economic Security and Health, and/or Community Services); the event or activity start date and duration; the target population(s) served; projected numbers to be served; the projected benefits to the community or clients served; and your approach or strategy for reaching your desired outcomes. (Required) Community Impact Grant
The Community Impact Grant will provide funds in the general range of $1,000 to $2,500 with the focus on encouraging outcome-based, collaborative efforts for community impact to nonprofit organizations serving one or more ACF grant priority areas.
Amount requesting ($1,000 – $2,500) (Required) Are other collaborative partners involved in the project? (Required) Select One Yes No List partners and role with project (Required)
Use the plus sign to add more partners
Are other funders involved in the project? (Required) Select One Yes No List funders and confirmed and/or pending amounts. (Required)
Use the plus sign to add more partners
Briefly describe how these funds will support your outcome-based and/or collaborative effort for community impact in roughly 500 words or less. Include your overall purpose/goals; the need and ACF priority focus area you are addressing (Youth Services, Economic Security and Health, and/or Community Services); your approach or strategy for addressing the need; the start date, duration, and end date of the project; target population(s) to be served; projected numbers to be served; projected outcomes/impact; and how outcomes/impact will be measured. (Required)