Grant Application

BENEFIT Fund Grant Application.

Contact Info

Please take a moment to review the application and required fields before starting.

* Indicates required field

Organization Name *

Contact Name *

Email *

Contact Phone *

Contact Title *

Website Address *

Mailing Address *

Application

Organizational Background: (Describe the history, mission, major programs, and key staff of your organization). *

Statement of Impact: What need does your organization or project address? What makes your organization or project unique? (Your organization or project must serve children in need in Loudoun County to Qualify) *

Goals and Evaluation: Describe your big picture goals and discuss the results that you intend to accomplish. How do you measure success, or how will you measure success (for new projects)? *

Upload Supporting Materials

IRS letter of determination *

Max file size: 20MB

List of organization’s current Board of Directors *

Max file size: 20MB

Most recent Form 990 or 990EZ *

Max file size: 20MB

Most recent audit or financial statement *

Max file size: 20MB

Board-approved organizational budget for the current fiscal year *

Max file size: 20MB

Video Submission

A video, no longer than thirty (30) seconds in length, which highlights the mission and work of your organization. Videos should include a general organizational overview, NOT the specifics of the BENEFIT fund request. Videos need not be produced professionally. Cell phone videos are acceptable. Creativity is encouraged!

Video URL (YouTube, Vimeo, DropBox, etc) *

OR Upload Video File *

Max file size: 20MB

Do you give permission for the video submitted as part of this application to be posted on the BENEFIT website and shared via BENEFIT social media accounts? *

Yes No

Submit

BENEFIT Fund Grant Application.

Event Location

Countdown to Crossroads Music Festival 2021

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