Online Application

Cover Letter

Grant Project Grant Project is required

Organization type Organization Type is required

EIN

Organization Name

SD # (Numerical only)

School Name

City Of

Municipal Organization Name

How did you hear about us?

Brief description of what grant money would be used for (max 300 chars) Grant Description is required

Amount Requested from CHC Amount Requested is required

Your Matching Funds Matching Funds is required

Total (Request + Match) Total is required

Project Location Project Location is required

County County is required

Application Organization (Name of Organization) Application Organization is required

Mailing Address Mailing Address is required

City City is required

State State is required

Zip Code Zip COde is required

(all formal correspondence will be mailed to this organization contact at this address)

501(c)(3) Tax Exempt Holder (Verification Must be Attached)

Project Contact Project Contact is required

Daytime Phone Daytime Phone is required

Evening Phone Evening Phone is required

Email Address Email Address is required

Additional contacts who may be contacted regarding this project (different from above).

Contact Contact is required

Daytime Phone Daytime Phone is required

Evening Phone Evening Phone is required

Grant Writer Grant Writer is required

Daytime Phone Daytime Phone is required

Evening Phone Evening Phone is required

Grant Application Grant Application is required