Grant Form – Supervisor Hilda L. Solis

Office of Supervisor Hilda L. Solis Board of Supervisors, First District County of Los Angeles Grant Application

Thank you for your interest in applying for a grant with the Office of Supervisor Hilda L. Solis. All applicants will receive a response in writing from our Office, but please note that your application will undergo a thorough and lengthy review. We appreciate your patience.

Please also note that personnel costs are discouraged since this grant is intended to be one-time in nature.

Lastly, State law requires you to disclose information about contributions made to Supervisor Solis by you, your organization, and agents paid to represent you or your organization. Failure to complete the declaration form at the end of this application in its entirety may result in delays in the processing of, and perhaps even denial of, your grant application.

Thank you for your service to the residents of the First Supervisorial District.

Name of Organization:(Required)

Organization Name

Application Date:(Required)

Is the applicant a non-profit organization? The organization must be a non-profit.(Required)

Yes

Address(Required)

Street Address City State ZIP Code

Organization’s Phone Number:(Required)

Organization’s Website:(Required)

Contact Person’s Name:(Required)

Contact Person’s Title:(Required)

Contact Email:(Required)

Contact Phone Number:(Required)

Organization’s Mission:(Required)

Number of people served by the organization per year:(Required)

Annual Operation Budget(Required)

Tax ID Number(Required)

Description of services the organization provides:(Required)

Program/Project Name:(Required)

Description of program/project:(Required)

Amount Requested:(Required)

Describe how the funds will be used:(Required)

Expected number of people who will be served:(Required)

Is this an existing or new program/project:(Required)

Existing

New

Describe how the organization measures or evaluates success of the program/project:(Required)

List the address(es) where the program/project will occur:(Required)

First District Area(s) to be served by proposed program/project. Select all that applies:(Required)

Project Service Categories (select all that applies):(Required)