Grant Application

Please fill out all the required fields. Otherwise, you would not be able to submit the form.



Contact Information
 Full Legal Organization Name:
 Street Address:
 City:
  State:   Zip Code:
Organization Website:
Organization President /
Executive Director:
Title:
 PHone Number:
  Email:
Contact Person:
Title:
 PHone Number:
  Email:
 
Organization Information
 501(c)(3)?:

  Year Established:
Fiscal Sponsor Name:
Fiscal Sponsor Address:
 Total Organization Budget:
  Total # Board Members:
 Total # of Staff:
  Total # of Volunteers:
Organizational Mission
Statements:
Brief Description of
Organization:
Brief Description of Services
Provided:
 
Grant Request
Program / Project Name:
Total Program Budget:
Requested Amount:
Percent of Total Budget:
Type of Request:
 
One-Time Request?:
Purpose of Requested Funds:
City Priority Funding:
Impacts on Cupertino
Community:
Staff Competency::
At Least 75% of Funding Will
Go Toward Direct Service?:
Usage of Prior Year's Funds:
Requests Made to Other
Agencies:







Note: Please fill out all the required fields. Otherwise, you would not be able to submit the form.