General Information

Name of Organization:

Date of Submission:

Funds Requested:

MIT Account #:

OR Payee for grant check:

(NOTE: Checks will be made out to organizations, not individuals.)

Address:

Contact Person Name:
Phone:E-mail:
Role:MIT Volunteer Organization Staff Other (please specify):

If the contact person listed above is not an MIT volunteer, designate one MIT volunteer to be the liaison to the CSF for your application.

Liaison's name :
Phone: E-mail:

List the names of all MIT volunteers who currently work with your organization. A CSF representative may contact these individuals to learn more about their involvement with the organization.

Organization

Briefly describe your organization (or the organization for which you are volunteering), its purpose and history, and who is served by it.

Number of paid staff:

Total number of volunteers (including MIT volunteers):

Project

Describe the project or programs you propose to use a CSF grant to support. If the grant is funding core operating expenses, please specify which expenses the grant will be used toward. Include an estimate of the number of people the porject or programs will serve.

Explain how your organization satisfies the Community Service Fund's funding guidelines. (See application criteria.)

Timeline

Over what period of time do you propose to spend the grant funds for which you are applying?

When will the project for which you are seeking funding be completed?

Do you anticipate that your organization will apply for another CSF grant? If so, when?

Has your organization applied for CSF funding before? If so, when was the last time your organization applied?

Describe (if applicable) how you have made use of previous CSF grants to your organization.

Budget

Please provide an annual budget summary of your organization AND a budget summary of the project for which the CSF grant funds will be used. Include an itemization of how the grant you are requesting would be spent. Also, please list any additional sources of funding and the amount expected from each source.

(NOTE: Formatting will be lost when you submit this form. Please feel free to email separate budget documents to Emily Paramore.)

How would partial funding of your CSF grant request affect your ability to carry out your programs or project?

or