Mini Grant Application Please enable JavaScript in your browser to complete this form. Date *Organization InformationLegal name of applicant organization: *Mailing Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhysical address, if different:Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeExecutive Director, President, or CEO name and tiltle: *Phone *FaxEmail *Contact title: *Phone *Website / URLYear organization was founded: *Organization's tax exempt # (EIN): *Organization's total operating budget for current fiscal year: *Amount of request: *Grant Request InformationFiscal agent: *Name of project: *Project abstract: *Please give a brief summary of project – if your grant is selected, this will be for public relations purposes.Beginning and ending dates of project/activity: *Total Grant RequestTotal cost of proposed project: *Amount requested in this application: *This request as % of total project cost: *List any previous funding received from the City of Ranson (e.g. – year, purpose & amount):This organization is (will be) requesting funds for (Please check all that apply): *AcquisitionBasic NeedsCapitalConstructionCrisis InterventionEquipmentFamiliesFixed AssetsHealthOngoing CostsProject/Program SupportRenovationRentSafety, Education, & TrainingStart-Up CostsSuppliesUtilitiesOtherCost of Acquisition:Cost of Basic Needs:Cost of Capital:Cost of Construction:Cost of Crisis Intervention:Cost of Equipment:Cost for Families:Cost of Fixed Assets:Cost for Health:Cost of Ongoing Costs:Cost of Project/Program Support:Cost of Renovation:Cost of Rent:Cost of Safety, Education & Training:Start-Up Costs:Cost of Supplies:Cost of Utilities:Other Cost:Total: *Date *Date *Submit