TMCF application - Graydient Creative



|Application Date:       |

|The Marcus Corporation Foundation Application |

|Organization |

| |

|Legal Name:       |

|(The name listed on IRS 501c3 determination letter—must have IRS 501c3 designation to be eligible) |

| |

|Employer Identification Number:       |

| |

|Organization Common Name (if different than 501c3 name):       |

| |

|Address:       City:       State/Prov.:       Postal Code:       |

| |

|Phone:       Fax:       Website:       |

| |

|Executive Director/CEO: First Name:       Last Name       Title:       |

| |

|Phone:       E-Mail:       |

| |

|Grant Writer/Contact Person: First Name:       Last Name       Title:       |

|(If different from Executive Director) |

| |

|Phone:       E-Mail:       |

| |

|Organization Fiscal Year:       |

|Request |

| |

|Project/Program Title (if applicable):       |

| |

|Grant Purpose:       |

| |

|Request Amount: $       Is amount fully deductible? Yes No |

| |

|Focus area of grant request (select one): |

|Arts & Culture Education Health & Human Services Community Development Conservation Other:       |

| |

|Geographic area impacted by requested funding: |

|Greater Milwaukee area Wisconsin Other:       |

| |

| |

| |

|Executive Director/CEO: __________________________________________________ Date: _____________________________ |

| |

|Type Name & Title:       |

| |

|The applicant, by applying for funds, hereby certifies that should a grant be made, the funds will be used in compliance with all applicable antiterrorist financing|

|and asset control laws, regulations, rules and executive orders. The recipient further agrees to take all reasonable steps to ensure that any individual, entity or|

|organization expected to receive the funds is not on any list of suspected terrorists made readily accessible by the Government of the United States. |

| The Marcus Corporation Foundation Application |

| |

|Narrative |

|Please provide in order listed below and do not exceed two pages |

| |

|Project Description |

|Describe project (if applicable) and how and when (note timeline information below), specifically, The Marcus Corporation Foundation funds will be used. |

|      |

| |

|Success Measures |

|Describe success measures:       |

| |

|Funding Considerations |

|Describe plans for obtaining other funding needed to carry out the project/program, and identify amounts requested of and /or received from other funders. |

|      |

| |

|Identify relationships with The Marcus Corporation (aka Marcus Hotels & Resorts, Marcus Theatres, etc.), i.e. list employees actively involved with organization, |

|noting in what capacity, etc., and any other relationships and support. |

|      |

| |

|Most recent contribution received from The Marcus Corporation Foundation including amount, title/purpose and date made. Also note if recipient of any other donations|

|from any The Marcus Corporation entity (see above). |

|      |

| Completed Application Must Include: |

|Current list of organization’s officers and directors |

|An itemized project budget (if applicable) including identifying other sources and amounts of support |

|A copy of the organization’s IRS 501c3 determination letter |

|The organization’s actual income statement for the past fiscal year, identifying the organization’s principal sources of support. Statement should indicate amount of|

|expenses relating to program services. |

|The organization’s operating budget with projected income and expense budget for the current fiscal year, identifying the project revenue sources (list other |

|funders). Budget should indicate amount of anticipated expenses relating to program services. |

| |

|Please send completed application in word (not pdf) document format, and scan application attachments (noted above) in one pdf document and email to: |

|foundation@ |

|Questions? Contact foundation@, 414.905.1778 |

| Timeline: |

| |

|October 1 for contribution requests to be considered at annual December Foundation meeting |

|Approved requests at the December meeting are generally processed for payment the following December |

|Approval notifications are made by February 28 |

|Payment processing can take up to 60 days |

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download