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NEB Corporate Grant Application

Date

Salutation

First Name

Last Name

Email Address

Institution/ Company Name

Department

Phone Number

Street Address

Building/Room #

Street Address 2 (if needed)

City

State/Province

Zip/Postal Code

Title of Request

Requesting Group (to whom the award, if granted, will be written):

Organization's Website:

Amount Requested

Please provide a brief summary of your grant proposal.

Additional Requirements: Please upload all information below (preferred). We have provided four upload fields but you may combine these and upload fewer files as needed. Alternatively, you may fill out the information above and then email the requested documents as attachments to [email protected] or mail the documents to NEB Corporate Donations Committee, 240 County Road, Ipswich MA 01983 if that is easier. Deadlines are April 1 and November 1 of each year. Questions should be directed to Fana Mersha by phone: 978-380-7283 or email at [email protected]

Please include a description of your organization and your request including specific details on the proposed use of funds and who will benefit from the project.

IRS 501(c)3 Exemption Letter or other legal proof of non-profit status (required).

Include a proposed budget for the project with information on other funding sources and/or fundraising activities if applicable. Please be specific with how the amount requested will be utilized.

Include any other materials you feel the committee should consider (e.g. Price Quotes for equipment or relevant photos).

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