Grant Inquiry Form – Benton Telecommunications Foundation

Organization Name *

Name of Contact Person *

First

Last

Address

Contact Email *

Contact Phone Number

EIN

Is your organization a public agency/unit of government *

Focus Area *

Location of Project *

Total Organizational Budget *

Total Project Budget *

Amount Requested-half the project budget up to $25,000 *

Explain the time line of your project(400 characters or less) *

Purpose of Grant(400 characters or less) *

Project Description(400 characters or less) *

Who will receive the greatest benefit from the funding?(400 characters or less) *

How will these funds directly be spent(400 characters or less) *

Explain, if there are any, other sources of funding(400 characters or less) *