Mission + Outreach Grant RequestPlease submit the form to be considered for a UCC Norwell Mission + Outreach Grant. Please select one New Funding Continuing Funding Amount requested $ Organization Contact person First Name Last Name Mailing address Address 1 Address 2 City State/Province Zip/Postal Code Country Telephone number (###) ### #### Fax number (###) ### #### Email address Website http:// Organization’s mission statement What is the legal name of the entity to which grant checks, should they be awarded, be written to? Please describe how you allocate funding for your organization (e.g., what percent is allocated to your administrative costs and what is the percentage allocated for other program support?) What is the purpose of this funding request or the name of the project? Please include a brief description of how the funding will be used (e.g., “to supplement client travel expenses”) Who will be the beneficiaries of this project? How many people? How will they be helped? Are there opportunities for “hands-on” service with your organization? If so, please describe. Is there any other information that we should have to best evaluate your proposal? Thank you for requesting a UCC Norel Mission + Outreach Grant. Please submit all questions or concerns to UCC Norwell via email.
