Organization Information

Name
Address
Point of Contact
Telephone
Email Address
Website URL
Provide names and resumes of key personnel (Directors / Trustees, Officers, Project Manager, etc.):

Tax Status Information

Federal Tax I.D
Exempt under IRS 501(c)(3) regulations? Yes
No
Public Charity Status Church
Hospital
Educational Institution
Government Unit
Other
Does the organization file an IRS Form 990? Yes
No

Request Information

Amount
Purpose
Percentage of grant request used for operating budget
Percentage of grant request used for special project/activity budget
Are matching funds available?
Is the request for multi-year payments?

Purpose and Activities of Organization

Summarize the purpose and primary activities of applicant organization

Project / Activity Information

If grant funds are for a specific project/activity, provide description of the plan of work, financial budget, and completion schedule

General Information

What percentage of the organization's annual budget is used for fund-raising?
What percentage of the organization's annual funds is used for salary and employee compensation?
Provide any other information pertinent to this application for consideration by the Russell Foundation

Certification and Acknowledgement

The undersigned hereby certifies that the information in this request is correct to the best of his/her information and belief. The undersigned acknowledges that all materials submitted will become the property of the Russell Foundation and will not be returned.

For the Applicant Organization:
Name
Title