Grant Form | AQUME Foundation

OUR JUSTICE Grant Fund

Partnership Form

Organization Name

Mission Statement

Please share the URLS showcasing your web presence

Website

Facebook

Instagram

Twitter

Contact First Name

Contact Last Name

Mailing Address Line 1

City

Zip Code

Mailing Address Line 2

State

Contact Email

Contact Phone Number

Please briefly tell us about your organization (Max 300 words)

Please share how a $2500 grant award can impact the work of your organization. (In other words, how would you use the grant dollars?) (Max 500 words)

How many people do you estimate this grant award will impact?

Please upload your organization's (or your fiduciary's) 501c3 tax exemption letter

Upload File

1. 1-2 photos that showcase how your grant was used.

2. 1 quote describing how the grant impacted your organization.

If awarded a grant, can you commit to the following post award follow-up with AQUME Foundation by October 15th, 2024?

Yes

Please upload a completed W9. version 2018

Upload File

I certify that all responses above are true to the best of my knowledge, and any intentional fraud may disqualify my organization from future funding opportunities.

Your Signature

Today's Date

I agree to the terms & conditionsView Terms Of Use

*Please check your email after submission to confirm we have received your form!

Thank you for completing this partnership form! We expect to announce awardees on August 15, 2024

This form no longer accepts submissions.