CHARITABLE GRANTS APPLICATION

How to Use This Online Form

Image Printing of South Carolina
845 California Ave
Spartanburg, South Carolina 29303

Application Form

Name of Charity

Parent Organization (if any)

Please list any and all organizations with which you are affiliated with

Tax ID #

Are you a registered charity with the Secretary of State in South Carolina?            Yes            No

If not, please describe what official status/credentials your organization has

Please list your web site address

Street Address 1

Street Address 2

City/State/Zip

Name of individual requesting grant           Phone number             E-mail address

Contact name for public relations/information       Phone number     E-mail address

Do you use paid fundraising companies?        Yes           No

Do you allow fundraiser's to keep a share of the contributions?     Yes           No

In what geographic region would the grant be primarily used in

Please list the names and salaries of the top five highest salaried individuals within your local organization

Please list the names and salaries and of the top five highest paid individuals within your parent organization

Have any of your paid staff been convicted of a felony involving theft, breach of trust, fraud or similar charges?     Yes           No

If we were to desire to speak with the President/CEO/Top Dog/Head Hauncho of your organization, would we have access to him/her?     Yes     No

Please describe in great detail exactly what our grant money would accomplish

Please describe in great detail the five most significant accomplishments of your organization during the past 12 months

What percent of all donations are used for administrative and fundraising costs

Since our funds are limited, why should we give your organization preference to other charities?

Does your organization make your service availability decisions based on race/religion/ or ethnic background?          Yes          No

Please make in comments or notes:

I certify that all information on this application is accurate and recognize that it is subject to verification.