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Miracle Outreach Entry Form
Please answer all questions completely and thoroughly.
Incomplete applications will be not be considered.
Name of Non-Profit Organization
Street Address
City
State
Zip
Phone
Website
Contact Name
Email Address
Title
Years of Operation
Mission
Amount of funding are you seeking (in U.S. dollars)
Describe in depth the reason your organization needs funding, detailing what the funding will be used for and who will benefit. If funding is for a specific project, please including cost, length of project, and estimated completion date
What geographic area will be served by your organization with the funding you seek
Name amount and source(s) of additional funding secured for the program or project
Describe how will you measure the success of the program/project where the funding will be used
Attach 501(c)3 document here
Attach Current Budget here
Attach Project Budget here
Attach Board Listing here
Attach Federal 990 here
• Copy of valid IRS letter granting 501 (c)3 non-profit status
• Board approved organizational budget for current fiscal year
• Project or Program budget
• List of Board of Directors, including professional affiliation
• Federal Tax Return 990
SUBMIT APPLICATION
