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  • ORGANIZATION INFORMATION
    • Organization Name Please enter valid data.
    • Date Organization Established Please enter a date.
    • 501(c)(3) Non-Profit ID# Please enter valid data.
    • Address Please enter valid data.
    • City Please enter valid data.

      State None AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY

      Zip Please enter a zip code.
    • Organization Phone Number Please enter a phone number.
    • Fax Number Please enter a phone number.
    • Email Please enter an email address.
    • Executive Director Name Please enter valid data.
    • Executive Director Phone Number Please enter a phone number.
    • Contact for This Request Please enter valid data.
    • Contact Phone Number Please enter a phone number.
    • Organization Web Site Please enter valid data.
  • Organization Profile
    • Mission/Purpose/Objectives

      Summarize and/or attach relevant information

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      Community Served
      (Approximate number of clients served annually)
    • Current/Most Recent Year Please enter valid data.
    • Prior Year Please enter valid data.

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    • Percentage of Client Base in Financial Need None 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 55% 60% 65% 70% 75% 80% 85% 90% 95% 100%
    • Basis of Financial Need Determination Please enter valid data.
    • Geographic Area(s) Served

      Location of Clients Served

      Please enter valid data.
    • Most Recent Annual Operating Budget

      Attach financial statement as appropriate

      Please enter valid data.
  • Funding Request
    • Amount Requested Please enter valid data.
    • Needed by Date Please enter a date.
    • Purpose and Benefit of This Grant If Approved

      Explain in detail and/or attach relevant information.
    • Impact to the requesting organization if this request is not/cannot be granted at this time: Please enter valid data.

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    • Does the Church of Christ the King currently or in the recent past provided other support to your organization ($s or other resources)? Yes No
    • If YES, please explain the nature and amount/type of support provided by Christ the KIng

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    • Other comments/background information helpful to the advisory board in reviewing this request:
  • Attachments Provided? Yes No

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    To submit supporting documents, please email as an attachment to srmaryjoseph@churchofchristtheking.org.

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