HOUSTON ROCKETS CLUTCH CITY FOUNDATION GRANT REQUEST FORM CLUTCH CITY FOUNDATION MISSION Established in 1995 by Rockets owner Leslie Alexander, the Clutch City Foundation is the philanthropic arm of the Houston Rockets. The mission of the foundation is to make a difference in the lives of those who are less fortunate---especially children. The Clutch City Foundation supports a variety of causes, with the primary focus areas being disadvantaged youth and families. Please assist in our review of your organization for a Clutch City Foundation grant and community partnership by providing the following information: I. OUTLINE OF REQUEST - Specific information regarding your charity; and if applicable, the project for which you are requesting funding: - Charity description - Amount Requested - Recipients: who will benefit from funding (include total number and demographics) - If requesting funding for a specific project, include a detailed description of project. II. ORGANIZATIONAL OVERVIEW - Verification of non-profit status: 501 (C) (3) Form - History - Purpose and/or mission statement - Description of services provided - Demographics of people served by your organization (age, ethnicity, socioeconomic level) - Board of Directors III. FINANCIAL INFORMATION - List of funding sources and revenue received for the past 2 years - Copy of financial statements for a minimum of past 2 years - Administrative Expenses (positions, salaries) Your prompt response to this request will greatly assist in our efforts to make a fair and impartial decision regarding your grant request. If you have any questions, please contact Sarah Joseph at (713) 758-7302. Please forward your completed information to the following address: Clutch City Foundation, Sarah Joseph, Toyota Center, 1510 Polk Street, Houston, Texas 77002 Email: [email protected] NOTE: Please note that this is a preliminary request for information, and that additional information may be requested to better understand your application. .