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Grant Application Information Form
This sample application was taken from the Massachusetts Cultural
Council grant application. The submitted application need not look
exactly like this, but should contain the same information.
Submission date:
Applicant Information
- Applicant name:
- Applicant name also known as:
- Address:
- Mailing Address (if different):
- City/State/Zip:
- Chairperson (name, title):
- Executive Director (name, title):
- Project contact (name, title):
- Daytime telephone:
- Fax:
- Summarize the mission of your organization:
- Last fiscal year total income:
- Last fiscal year total expenses:
Project Information
- Title of project:
- Summary of proposed project:
- Project start date:
- Project end date:
- Number of individuals directly participating in/benefitting from
this project:
Amount Requested:
Authorized Signature:
- The signature below is that of the person authorized to testify
as to the accuracy of this application (signature/title/date):
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