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ERC Helping Hands Grant Application

To submit a grant request, please complete the form below.

Organization

Organization Name: *

Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Contact Person

Name: *

First

Last

Title:

Email: *

Phone: *

Website / URL:

Program Information

Program Name: *

Requested Amount: *

Purpose of Support: *

How will funds raised for the program be used?: *

Area/Community Served: *

Estimated number of people served by this program: *

Date of Program:

Name/Signature: *

Additional Information Needed

In addition to a completed application, the following information is requested:

-A copy of the 501(c)(3) letter from the IRS
-Most recent financial statement
-Most recent Annual Report
-Organization’s mission statement and history
-List any ERC, Incorporated employees involved in your organization

File Upload:

Click or drag files to this area to upload. You can upload up to 5 files.

*Uploaded documents must be in Adobe .pdf or MS Word .doc format.

Comments:

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