New Project Request

About Your Organization

Contact Person Name

First

Last

Contact Person Title

Organization Name

Physical Address

Address Line 1

Address Line 2

City

State

Zip Code

Do you use a different mailing address?

Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

Contact Number

Email

Website / URL

Please Tell Us About The Project That We Are Adding/Updating

Project Name

Project Description

Describe the project's target population (if applicable)

Project Status

Project Start Date

Project Duration

Project End Date

Is the project address the same as the Organization's address?

Project Address

Address Line 1

Address Line 2

City

State

Zip Code

What are the hours of operation for this project?

What geographical area is served by this project?

Is there a fee associated with this project? If yes, please explain.

Please list your top 3 goals for this program

Project Budget

What is the total budget (amount) for this project? If you are unsure, please estimate.

Let's get specific. We'll need to know your project expenses.

List all costs associated with this project. (e.g. rent $750, salaries $35,000, supplies $1,500, etc.)

How much are you seeking in grants for this project? (*Unless otherwise promised, Dewlyn Nonprofit Services will not seek funding exceeding $250,000)

What is the purpose of this request (e.g. specifically how will funds be used)?

What other sources of income/funding does this project have? (list donor name and amounts given)

Additional information about the program?