The Community Foundation Serving Boulder County

Organization Summary

Note: This Organization Summary is also available for download in Microsoft Word format; you can download it and fill it in on your own computer.

ORGANIZATION NAME:

_______________________________

ADDRESS:

_______________________________________

CONTACT PERSON:	_______________________________
	(Name)
	__________________________
	(Title)

PHONE:	Office	_____________________
	Fax	_____________________

EMAIL:

____________________________________

WEBSITE:

___________________________________

Does 100% of your Board contribute to your oganization?

Yes

PURPOSE OF GRANT:

	General Operating (support for the organization as a whole)
	Special Program or Project (specific activity of the organization consistent with its mission)
	Capital Expenditure (funds spent for additions or improvements to plant or equipment)
	Endowment
	Technical Assistance
	Other

BRIEF BRIEF DESCRIPTION OF REQUEST:

__________________________________________________

__________________________________________________

__________________________________________________

AMOUNT OF REQUEST:__________________________

FISCAL YEAR END:______________________________

___________________________________	____________
Signature, President, Board of Directors	Date
___________________________________	____________
Signature, Executive Director	Date