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St. John's Episcopal Church Micro-Grant Application

Organization

Address

Contact person

Phone number

Email

Non-profit status

Annual operating budget (including copy of annual budget and/or financial report)

Type of service provided

Location of community served

Approx. number of individuals served annually

Major sources of funding (including organizations and amounts)

Amount of gift requested from St. John's ($250 - $2,500)

Please list past gifts from St. John's (including years and amounts)

How would this year's gift be used? Who would benefit?

List St. John's members actively involved in your organization

Please upload files (including financial documents or any additional information you wish to be considered)

Signature of person completing this form

Signature

Today's date