Part A
Funding Request
General Information: (All applicants please fill
in the below information. Applicants requesting
more than $1,000, move on to Part B)
1. Name
2. Address
3. Email address
4. Name and Title of contact person
5. Dates of
Events
6. Amount
requested
7. Briefly
State the purpose of the event as well as how it
relates to tennis and the Atlanta area:500
character limit*
8. Are there any persons/organizations
providing funding for your project and if so,
who are they? If not please answer No for this
field.500
character limit*
9. What percent
of your budget is being funded by us and what
percent by others?
10. How did you
hear about the ALTA Foundation?150 character limit*
Part B
Organization Information (All applicants
requesting more than $1,000.00 but less than
$5000.00 please fill in the following
information)
1. Year organization was established
2. Number of Employees
3. Please provide a detailed description of
the organization and how it relates to tennis
4. Name as
registered with the Georgia Secretary of State
5. Organization
named in 501 (c) (3), if different
6. Website
address
7. Total
operating expenses for the last fiscal year
8. Please
provide three references with addresses, phone
numbers and relationship.
A. Reference 1
B. Reference 2
A. Reference 3
Part C
Proposal Narrative
(All applicants requesting over $5,000, please
fill in Part A, Part B and Part C) Please
provide the following information.
Background:
Organizations mission, history, overall
goals and/or objectives. Describe current
programs and activities. Provide a
description of formal and informal
relationships with other organizations.2000
character limit*
Provide a list
of current and proposed funding sources for
your organization and what you have received
to date.2000
character limit*
If applying for
general operating support, briefly state how
this grant will be used.2000
character limit*
If your request
is for a specific project please provide the
following information: the community and/or
agency needs or problems that this effort
will address, including population served.
Program description to include strategies
employed to implement the proposed project:
a) goals and objectives and b) program
methodology.2000
character limit*
Evaluation:
Explain how you will measure the
effectiveness of your activities. Describe
the results you expect to have achieved by
the end of the funding period.2000
character limit*
Part D
Please provide the
following additional information if the request
is over $10,000Please
do not use this online submittal form if your
request is over $10,000.00 . Instead you
should print this form, complete it and mail it
to the appropriate address. All of the required
information for Part D should be included.
List of
officers, their prior history, and board
members.
Copy of IRS
Federal Tax Exemption Determination Letter
501 (c)
Most recent
annual report including financial statement
(Audited, if available)
Budget for the
project for which you are applying for
assistance
Operating
income and expense budget for current fiscal
year.
Capital budget
Assurances
If the grant is made, the
grantee agrees to provide The ALTA Foundation,
Inc within 90 days of receipt an accounting of
how the grant money was used, and a description
of how well the project met the grantee’s
original objectives.
The foregoing is
certified to be true to the best of our
knowledge, information and belief.
Name of Requesting
Organization
Signed By (Print Your Name)
Please Print Your
Name again
Official Capacity of Signed
Date: Example - February
21, 2005
LISA WHIGHAM
foundationpresident@altatennis.org
