Grant ApplicationReady to apply?First, let's make sure you qualify to apply for a grant.Are you a 501(c)(3) non-profit organization?*Please ChooseYesNoGreat! Let's proceed with the application.Sorry, but we only accept applications from 501(c)(3) organizations at this time. OrganizationOrganization Name*Tax ID Number*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact InformationContact Person First Last Title*Phone*Email* Website Information About Your OrganizationOrganization biographical narrative (origin, history, board composition, staffing, volunteer involvement, mission, major accomplishments, etc):*What specific services or products are provided? Give examples.*How are services or products delivered?*What areas are serviced by the organization (geographic, demographic, etc)?*Organizational FundingAnnual Budget:*% of funds used for overhead costs:*% of funds used to directly provide services or products:*Funding Sources*Grant Request InformationGrant amount requested from the Hansen Family Foundation?*For what specific purpose(s) will the grant be used?*If this grant will be used for a specific project, how will the grant money be distributed?% of project total:*% to overhead costs:*% to delivery of direct services or products*Will grant money will be used for building construction or improvements:*Please ChooseYesNo% to building construction or improvements:*% to overhead costs:*Describe your fundraising plan.*Provide copies of any competitive bids. Drop files here or Provide property insurance information.Coverage AmountInsurance CompanyIf your organization previously received grant money from the Hansen Family Foundation, how were those funds used?Additional CommentsPhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.