The Lens Arisia Inc

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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):







webmaster@arisia.org.
Last updated 20 February 2006.

Arisia, Mentor of Arisia, and the distinctive Arisia Lens are service marks of Arisia, Inc.
Original content copyright 2005 Arisia, Inc.
Further legal minutiae here.