THE WESTFIELD FOUNDATION

P.O. Box 2295

Westfield, NJ 07091

GRANT APPLICATION
Revised January 2002

(REFORMATTED COPIES OF THIS APPLICATION FORM PRODUCED
IN YOUR COMPUTER ARE ACCEPTABLE)

Note:   Applications for grants should be in writing and must be submitted by the first of January, April, August or October to be considered at the Trustee meeting held in February, May, September and November.

1.  Date of Application: __________________________________________________________________

2.  Organization's registered name and address: ______________________________________________

    ____________________________________________________________________________________

3.  Amount of request ____________________________________________________________________

4.  Attach the following:
        a) A listing of current Board of Trustees and Officers.
        b) A copy of your 501(c)(3) certificate of tax exemption (unless already on file)
        c) Most recent audited financial statement (unbound)
        d) Current annual budget

5.  Attach a narrative describing the organization's overall purpose and number of individuals served over the past year.

6.  Attach a narrative describing the organizations relevance to the community of Westfield and number of Westfielders served over the past year.

7.  Attach a description of the specific project for which support is sought, including:  (please respond to all)
        a) its relevance to the community needs of Westfield;
        b) the proposed time-frame of the project;
        c) a specific cost analysis;
        d) any plans you may have for raising matching funds;
        e) identification of other grantors being solicited for this project, with amounts requested
            and/or granted;
        f) plans for future funding, if the project is to be ongoing.

8.    Please state name, address and phone number of contact person who will be
       responsible for this project's implementation, expenditure of funds and
       project evaluation. (The Foundation will require periodic and final project reports along with
       verification of funds expended.)

        __________________________________________________________________________________

        __________________________________________________________________________________

        __________________________________________________________________________________
 

Submitted by: ________________________________________________________
                        (Signature and Official Title)