Grant Request Grant Request (online) Please complete the following information: Please enable JavaScript in your browser to complete this form.Your organization name *Name *TitleEmail *PhoneOrganization EIN numberYear your 501(c)(3) was grantedAddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWebsite / URLWhat best describes your organization's operating model?Brick and MortarFoster BasedOtherIf Other, please describe your organization's operating modelWhat best describes your organization's staffing?Fully Volunteer OperatedStaff and Volunteer OperatedFully Staff OperatedOtherIf Other, please describe your organization's staffingGive us a brief description of your organization's mission and purposeGive us a summary of your organization's annual impact and notable accomplishmentsHow much funding are you requesting (up to $2,000)? *Enter the amount in US dollars. Requests are limited to $2,000.Describe what you are requesting funding forHow will this funding request support your mission or programs?If you are purchasing items or services with this request, please detail the cost breakdown hereIf you have links to the items, you can insert them here. Put commas between multiple links. You can also upload budget details at the end of this application. NOTE: Receipts will be required with your final grant report.Is there anything else you would like us to know about your organization, impact or request?If support is granted, are you able and willing to share a Facebook post tagging The LeBel Foundation as a thank you? *YesNoOtherIf Other, please explain your Facebook acknowledgment responseIf granted, do you agree to submit a funding report with receipts of purchases and impact outcome by the deadline noted on your award letter? *YesNoUnderstand that if this deadline is missed, your organization will be disqualified from future funding support for two years.If you would like to upload supporting documents, you can do so here Drag & Drop Files, Choose Files to Upload You can upload up to 5 files. Upload up to 5 files. Maximum 10 MB per file. Accepted formats: PDF, Word, Excel, JPG and PNG.Submit Grant Application
