Kurt Pearson Social Concerns Fund Grant Application

Submitter Name

Submitter email

Submitter telephone number

How did you hear about the grant?

Organization Name

Is this organization a 501(c)3 nonprofit?
YesNo

Organization Address

Contact person at organization and title

Phone number and email address (if different from above)

Estimated project budget (if applicable):

Grant amount requested (Grant amounts are < $2,000):

Annual organization budget

Please tell us about the mission and the goals of the organization and project to be funded:

Please tell us about how the organization will use the grant and the expected impact: