ADVISORY NEIGHBORHOOD COMMISSION 3E
TENLEYTOWN AMERICAN UNIVERSITY PARK
FRIENDSHIP HEIGHTS
c/o Lisner Home 5425 Western Avenue, NW Washington, DC 20015
www.anc3e.org
GRANT APPLICATION
Grants are available only to non-profit organizations; individuals may not apply. Applicant organizations must provide services to residents of ANC 3E. Within 60 days of the issuance of any grant, the grantee must provide to the Commission a statement as to the use of the funds consistent with the grant application, complete with receipts that support the expenditures. Grants may be submitted by e-mail to sherryacohen@gmail.com or mailed to ANC 3E c/o: The Lisner-Louise-Dickson-Hurt Home at the address above.
Please complete all items. Incomplete applications will be returned and not considered. Attach additional pages if needed.
1. Applicant Organization Name__________________________________________
Address________________________________________
_______________________________________________
Contact Person___________________________Telephone______________________
Fax___________________________
e-mail_________________________
2. Project Information
Name of Project_________________________________________________________
Description of Project_____________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Location of Project_______________________________________________________
Total Project Cost_____________ Grant Request_________________
Where will additional funds needed to complete the project come from?_____________
______________________________________________________________________
Describe the benefits to the residents of ANC 3E _______________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Attach a complete budget for the proposed project.
The expenses must be incurred within 60 days of receipt of funds or a signed contract must be submitted to the Commission. Once the contracted services are complete, which should be done within 6 months from receipt of funds, the grantee must forward a copy of a paid receipt to the Commission. The funds may not be used for routine expenses.
As a duly authorized representative of the Applicant, I submit this grant request.
Date__________________________ Signature______________________________
Print Name____________________________