CHARITABLE ORGANIZATION REQUEST FOR DONATION

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If you are apart of a Charitable Organization and would like to inquire about a grant from the Rob Benzon Foundation, please fill out the form below.

 

    Request for Donation Application - Charitable Organization Form

    Legal name of charitable organization and 501(c)3 number

    Contact person/title from organization

    Contact Email

    Contact Phone

    Additional Contact information and website

    Donation amount requested and how this figure was determined?

    Requested date for receipt of donation?

    Organization Information

    Please provide the following information in the box below.

    • Summarize your organization’s history.
    • State the organization’s mission and goals.
    • Outline current programs and activities.
    • Highlight organizational accomplishments.

    Purpose of Donation

    What is the purpose of this donation? Write about the following in the box below.

    • Describe the proposed use of the donation.
    • Identify the target community served and how they will benefit.
    • How will you reach this community?
    • Explain how the donation will contribute to and/or impact the community.
    • Provide a timetable for use of the donation.
    • Is this a request for a one-time donation or annual giving?

    Promotion and Award of Donation

    Describe how this donation with be promoted in the community? Write about the following in the box below.

    • How will this donation be promoted in the target community?
    • Will the Rob Benzon Foundation be named specifically during the promotions?
    • Is there any type of check presentation or award banquet planned?
    • How can the Rob Benzon Foundation stay informed about the use of the donation?

    Once we receive your information, we will be following up with you to provide the following:

    • Copy of the current IRS determination letter indicating 501(c) 3 tax-exempt status.
    • List of Board of Directors including affiliations, tenures, and terms. What percentage of the Board of Directors financially supports the organization?
    • Annual Report (if available)
    • List of other donating organizations and/or potential donators and amounts committed or requested.

     

    The Director of Grants will review the application and then contact you to discuss the grant request further. We appreciate your understanding that to fulfill our mission, our responsibility to the donors and our 501(c)(3) responsibilities, a thorough vetting of each grant application is required.