Riz Kids Partners for Change Grant Application – D.C. Area

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General Information

Mailing Address
Date of Application

Primary Staff & Board of Directors

Primary Staff Contact Information
List the following for each primary staff person for the organization.
Name
Title
Phone
Email Address
 
Board of Directors, Officers and/or Committee Members
List the organization’s Board of Directors, Officers and/or Committee Members.
Name
Board Position
Employment/Organizational Affiliation
 

Organizational Overview

List the number of employees.

Program and/or Project Overview

Identify the DC Wards that will benefit from this grant (check all that apply)

Budget & Funding Information

  • A detailed outline of your organization’s overall budget, including line items for income and expenses.
  • A budget for use of the grant funds and a description of how grant funds will be used.
  • A copy of an active business license issued by the District of Columbia Department of Consumer and Regulatory Affairs (DCRA) – Corporations Division (indicating an “active” business license at the time of application, and agreeing to maintain such status throughout the grant period).
  • A copy of an annual financial audit conducted by a certified public accountant for the organization’s most recent fiscal year; or if the organization does not have a financial audit, a copy of the organization’s IRS Form 990 for the most recent tax year.
  • A copy of the determination letter from the IRS confirming the organization’s 501(c)(3) status; and a copy of the letter from the DC Office of the Chief Financial Officer, Office of Tax and Revenue confirming the organization is exempt from DC income and franchise taxes.
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      Acknowledgment of Funding Guidelines (please check box below)*
      List all District of Columbia government agencies and private sector companies or organizations from which your organization has received grant funding over the past two years.
      Agency/Organization Name
      Award Year
      Award Amount
      Program/Project Supported by Grant
       

      Applicant Certification

      I certify, to the best of my knowledge, that the information contained in this application is accurate, and that I am authorized to make this Application. I accept the terms and conditions of the Events DC Community Grant Program as outlined in the Guidelines for Applicants.
      Please type your full name above to serve as your electronic signature.
      Date