NACC GRANT APPLICATION FORM
Spring 2009 Funding Cycle



Date Received:___________

Grant applicant please fill out the following:

Date ___________________

Name of Organization______________________________________________________________

Address_________________________________________________________________________

________________________________________________________________________________

Telephone___________________   Fax______________________   Email____________________

Contact Person___________________________________________________________________

Address/Phone/Email (if different)____________________________________________________

________________________________________________________________________________

How did you hear about NACC?  ____________________________________________________

Has your organization ever applied for a NACC grant before?  ________   If yes, when?  ________     Has your organization ever been funded by NACC before?  ________  If yes, when?  __________

In addition to answering the questions on pages 2-5, please include the following with your proposal:

Written references are optional:  we will definitely consider written references (limit 3) that are submitted with your proposal, but they are not required.  References should be no more than 2 pages in length and the writer should state his/her relationship to your group.

Supporting printed material such as newsletters, brochures and flyers (limit 3) may be submitted.

Please Note: Try to use only the space provided in the following pages for your responses.  If you need more room for any answer(s), you may use an additional sheet of  paper.  You may also retype the questions on your computer.





NACC Grant Application Form, page 2

1)  Amount requested:  ______________________

2)  Describe the specific project for which you are applying for funds, and attach an itemized budget breakdown (income and expenses) for the project.  Make sure to comment on the following:  1) the creative and/or direct action aspects of the project, 2) whether the project creates positive alternatives to the societal/political status quo, and 3) the proposed impact of the project.
























3)  Expand on the goals, objectives and strategies you have for implementing this project.  Please be as specific as possible in providing specific, measurable objectives.














NACC Grant Application Form, page 3


4)  Tell us about the history and goals of your group











5)  Other than the project for which you are requesting funds, please briefly describe other current and future events and/or projects.

















6)  How does your group operate?  How do you make decisions?  How many members are there?













NACC Grant Application Form, page 4


7)  Please attach your group's last complete annual financial budget (both income and expenses) as well as your projected budget for the current year.  (This is in addition to a budget for the project for which you are requesting funding.)

8)  Which other grants have you received in the past?  Are you applying for other grants for this project?






9)  What is the make-up / diversity of your group in terms of age, race, sexual orientation, class, gender?  Have you taken steps to increase diversity?













10)  Do you work in coalition?  How do you work on other national and international issues?  On what issues and with which groups do you work?  Do you belong to a national organization or party?  If yes, which?















NACC Application Form, page 5

GRANT APPLICATION CHECKLIST


In order to assist you with the Grant Application process, we have included this Checklist to help you make sure that your Application is complete.  Please enclose each of the following materials with your request.  Incomplete applications will not be considered and may be returned.  If you have any questions regarding these enclosures, please call the NACC office for assistance.


	Cover Letter (including a brief description of the project)
	Grant Application Form (one copy)
	Annual Budget (including a breakdown of income and expenses)
	Project Budget (including a breakdown of income and expenses)
	Optional:  Three (3) written references 
	Optional:  Supporting printed materials (up to three items)

NACC
P.O. Box 85541
Seattle, WA 98145
206-547-0952
nacc@drizzle.com
www.seanacc.org