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Behmann
Brothers Foundation
2025 Grant Application
1.
Date:______________
2.
Organization Name:_____________________________________
3.
Mailing
Address:_______________________________________
4.
City:______________________________
State:_____________________ Zip:_____________________
5.
Telephone:______________________________
Fax:____________________________________
6.
Website Address:_______________________________________
7.
Employer Identification
Number:____________________________
8.
Name and Contact Information of Individual Responsible
for this Grant Request:
Name:______________________________________________
Title:_______________________________________________
Telephone:__________________________________________
E-Mail:______________________________________________
9.
Grant/Project Title:_____________________________________
10.
Amount of Grant Funds
Requested:$_________________________
11.
Type of Request: _____General Support
_____Start-Up Costs
_____Project Support _____Scholarship/Endowment
_____Technology Upgrade _____Capital Expenditure
_____Other
If
Other, please
explain:____________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
12.
What is the organization’s mission statement?
(Please do not exceed the space provided.)
13.
Give a brief description of the project or activity for
which grant funds are being requested. This description should
include the purpose and the goals to be achieved. (The summary
should not exceed this space.)
14.
Summarize the organization’s history i.e. how it came to
be a nonprofit charitable organization, etc. (The summary should
not exceed this space.)
REQUIRED
INFORMATION AND ATTACHMENTS
Please
include the following information with this application:
Attach as
Exhibit “A” a copy of the organization’s most recent IRS
Determination Letter showing 501(c)(3) tax-exempt status.
Has the organization's 501(c)(3) status ever been revoked? Yes
⃞
or No
⃞
If yes, please
explain:____________________________________________________________
Attach as
Exhibit “B” a copy of the organization’s most recent tax
return.
Attach as
Exhibit “C” a current list of Board of Directors, listing
addresses, occupations and community affiliations.
ACCEPTANCE
OF TERMS
If your
grant request is approved, will you execute and abide by the
terms of our Grant Policies?
⃞
Yes, I agree to abide by the terms of the Grant Policies.
I,
___________________________(title)_______________________of ___________________________________________
(organization) have
reviewed this application and believe it to be true, correct and
complete. I further represent that the governing body of the
organization authorizes the making of this request.
Behmann
Brothers Foundation
P.O. Box 271486
Corpus Christi, Texas 78427-1486
Sherry M. Kosarek, President
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