Sam Mazza Foundation

Home > Grantmaking > Preliminary Application

Our preliminary application form has been designed to give us a sense of your organization, its needs and the project or program you are seeking funding for. The application form is broken into three main sections:

1) Organizational information and background
2) Financial information
3) Summary of project or program to be funded

Before beginning the online application form, we encourage you to review the application questions and collect the information you will need to complete the form. You can download a sample application for review by clicking here.

Step 1 of 4

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1. Organizational information and background
Organization name:*
Address:
Street AddressAddress Line 2CityState / Province / RegionZip / Postal CodeCountry
Contact name:*
FirstLast
Contact title:*
Phone:*
Fax:
Email:
Date your organization was founded:*
MM
DD
YYYY
Brief statement of your organization's mission:*
(300-character maximum)
What populations does your organization serve?*
Board of directors:*
Please include a list of your board members and their email addresses.

2. Financial information
Date fiscal year begins:*
Current year projected revenue:*
Current year projected expenses:*
Revenue last fiscal year:*
Expenses last fiscal year:*

3. Summary of project or program to be funded
Requested grant dollar amount:*
Brief description of the project or program:*
(500-character maximum)
What benefits would the program/project produce?*
(500-character maximum)
Is the project/program a collaborative effort with any other organization?*
- Yes
- No
If yes, please provide the name of the organization:
Proposed starting date of project/program:
Proposed ending date of project/program:
Total project/program budget:*
How would the budget be funded?*
List primary sources, both confirmed and potential, in addition to potential funds from the Sam Mazza Foundation.
How exactly would the foundation's grant funds be used?*

4. Form completion
By submitting this form, you pledge that the information contained is true and correct.
Name (first and last):
Title:
Date:*
MM
DD
YYYY

Preliminary Application

Step 1 of 4

1. Organizational information and background

2. Financial information

3. Summary of project or program to be funded

4. Form completion