Required Information Sheet

Instructions:
After you fill out this required Grant information sheet, you may print this document and mail, or fax this information along with the other five required pieces of documentation. You may also attach this Required Information sheet to an e-mail and then mail or fax the other five required pieces of documentation to The Cyrus Eaton Foundation.

___________________________________________________________
Date of Application:
Have you applied to the Foundation before?__yes __no

___________________________________________________________

Organization Name:

___________________________________________________________

Address:

___________________________________________________________

City: State: Zip Code:

___________________________________________________________

Telephone Number: Fax Number: E-Mail:

___________________________________________________________

Person to Contact Regarding this Proposal:

___________________________________________________________

Project Budget:

Amount Requested :

___________________________________________________________

Type of Request:
(please check appropriate category)

__Start-up __ General Support __ Project

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Category:
(Check One)

__ Arts __ Conservation __Education

__Health and Welfare __ Public Affairs ___Science

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___________________________________________________________

Total Organization Budget: Budget Last Year:

Please provide a summary of your organization’s mission:

(1-3 sentences)

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Summarize your project or operating request: (1-3 sentences)

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What population do you serve? What geographic focus?

(1-3 sentences)