200 Anchor Drive, Suite B, Key Largo, FL 33037

200 Anchor Drive, Suite B, Key Largo, FL 33037 Telephone: 305-367-4707 • Fax: 305-367-6327 www.orfound.org • [email protected]

GRANT APPLICATION Applying organization must be classified as a tax-exempt entity under Section 501 (c) (3) of the IRS code guidelines. Please note that only projects specifically benefitting the communities of Homestead, Florida City and Key Largo, Florida will be considered. Please see our website www.orfound.org for Grant Guidelines & Policies

ANNUAL APPLICATION DEADLINE: January 31st (Grants awarded each spring) A signed hard copy of the Grant Application including all required supporting documentation must be postmarked by the Annual Application Deadline for consideration. This application may be completed in Microsoft Word or Open Office. The fields will expand to fit your entered information. For application assistance, please contact the Administrator at [email protected] or 305-367-4707.

ORGANIZATION OVERVIEW Organization Name: Full organization name Federal Tax ID Number: Required Address: Number, Street, Suite # City City State: FL Zip: Zip Code Phone: Main Number Fax: If none, type None Website: If none, type None Primary contact: Name: Dr., Ms., Mr. First Last Title: Title Phone(s): Include extension and/or cell # Email: Single address, please State the major goals of your organization and describe the population served: Overall organization goals. Specific grant project goal listed later in application. Please limit to 250 words. Actual number of clients served in the past fiscal year: Total Organization Clients Actual number of clients for the project for which funds are being requested: Grant Clients Only

GRANT REQUEST Grant Amount Requested: $ 0.00 For Fiscal Year: 20XX Total Project Budget: $ 0.00 Amount Requested from Other Sources: $ 0.00 Please indicate if you have applied to the following Ocean Reef organizations for this project: Keys Children’s Foundation: Amount: Requested $ 0.00 Ocean Reef Conservation Association: Amount: Requested $ 0.00

PLANNED GRANT PROJECT Project title: Brief Descriptive Title State the need to be addressed: Briefly describe community/client needs covered under this grant. Please limit to 500 words. State the proposed solution to the need, the time frame for it to be operative, and indicate how the grant will assist the solution: De scribe in more detail how this project will work, including timing and budgeting within project. Please limit to 500 words. Does the population to be served work with you, and to what extent? Brief Description. Please limit to 500 words.

Ocean Reef Community Foundation Grant Application Page 1 of 2 FISCAL INFORMATION Current actual sources of funding and the amount: Source: Funding Program or Organization Amount: $ 0.00 Source: Funding Program or Organization Amount: $ 0.00 Source: Funding Program or Organization Amount: $ 0.00

Sources of funding sought but not yet received, and the amount: Source: Funding Program or Organization Amount: $ 0.00 Source: Funding Program or Organization Amount: $ 0.00 Source: Funding Program or Organization Amount: $ 0.00

SUPPORTING DOCUMENTS Please confirm that the following required items are attached to this application: Income/Expense budget for the fiscal year for which funds are being requested and Income/Expense report for the immediate past two years. A copy of the latest annual auditor’s report or financial statement. A copy of the last IRS Form 990 filed. A copy of organization’s IRS Exempt Approval Letter Optional attachments: mission statement, brochure, other printed materials

SIGNATURE AND CERTIFICATION I certify that all information submitted in this application for funds from the Ocean Reef Community Foundation, Inc. is accurate.

Name: Authorized Representative Title: Title

Signature*:______Date**:

* Original signature required.

**Postmark and not completion date is used in determining whether an application meets the deadline. Final application with all supporting documentation must be postmarked by deadline on page one. Email submissions are not considered.

Ocean Reef Community Foundation Grant Application Page 2 of 2