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Grant Application Form

Please fill out the application and click submit at bottom when complete. If you need to save your progress and come back later to finish, then click the "Save and Continue Later" link at the bottom of this form. You will be emailed a link that will allow you to return and finish the form where you left off.

You will receive an email with a copy of your application once it has been submitted.

Grant Application

Organization Name*
Website Address
Employer Identification Number*
Please Provide Your Address Below*
Street Address Address Line 2 City State Zip
Mission Statement and Services Offered:*
Use of previous grants from Nagel Foundation:*
Other organizations from which you receive aid:*
Are financial statements available?*
Please send previous year tax form 990, Balance Sheet and P&L
- Yes
- No
Do you receive federal or state government grants or funding, including reimbursements?*
- Yes
- No
If you answered yes to the above question, what percentage of your annual budget is from government funding?
Name of person submitting application:*
Title or position:*
Email*
Phone*
Grant amount requested:*
Purpose of grant:*
Program timeline:*
Geographical area to be served:*
Who and how many will be served:*
List other funding sources, pledges and amounts for this program to date:*
How will this program be evaluated and what will be considered a successful outcome?*
Outline or attach program budget:*
Additional comments:*
Nagel Foundation recognition*
- We agree to display Nagel Foundation logo and/or give appropriate recognition on website, and on printed and promotional materials related to the program, if funded.
Checklist
- Email or mail your 501(c)3 IRS tax-exempt status letter
- Email or mail your previous year federal tax form 990
- Email or mail your financial statements (Balance Sheet and P&L)
- Program budget outlined or attached
- Email or mail supporting documentation (optional)

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