How To Apply

Grant Summary Form

In order to assist us in being more responsive to your request, please complete this Summary Form. When you submit this form, you will receive an email confirmation and a request to attach and submit your two-page letter of inquiry. This Summary Form serves as a supplement to your letter of inquiry and will not be considered as a request on a stand-alone basis. When you submit this Grant Summary Form, you will receive a confirmation email that contains the information you submit in this form. The email also will prompt you to attach your two page letter of inquiry.

1. Organizational Profile
Organization Name:*
Organization Director/CEO:*

Title:*
If other title, please enter:

Organization Mailing Address:*
City:* State:  
Zip:*

Phone:*
Fax:
Email:*
Web site Address:


Person to contact about your organization's request for funding (if different from above)
Name:
Title:
Email:
Mailing Address:
City: State:  
Zip:

Phone:


Organization's Background/Mission:

 


Organization's total operating
costs in its last fiscal year:*

Organization's Fiscal Year End:*

Tax ID #:*
Tax Exemption Date:*


If your organization does not
have 501(c)(3) tax status, select
which of the following applies
to your organization:
If you selected Utilizing a
Fiscal Agent, please provide the
name of your fiscal agent:
If funded, check should
be made payable to:


2. Grant Request Summary
Proposed grant pertains to which
of the following initiative areas?
Please refer to About Grantmaking


Include a brief summary of your proposed project, including a description of how the grant funds would be used:

 


Total Project Budget:
Amount Requested:
Grant Term:
If other, please enter:
If applicable, # of individuals served:
Project Start Date:
Project End Date:
Type of Funds Requested:


If appropriate, please choose any specific funding considerations (select one):


Proposed grant addresses the following areas (select all that apply):








Geographic area to be served
by the proposed project:
If other, please enter:


When you submit your Grant Summary Form, you will receive a confirmation email that contains the information you submit in this form. The email also will prompt you to attach your two-page letter of inquiry. If you prefer, you may mail your letter of inquiry to:

Grants Manager
The Virginia G. Piper Charitable Trust
6720 North Scottsdale Road
Suite 350
Scottsdale, AZ 85253

NOTE: For complete details on what information to include in your letter of inquiry, please refer to the How To Apply section.


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