Matching Funds Request Form

Matching Funds Request Form

* Attention: if this application is not fully completed the application will not be accepted.

Charitable Organization

We need every organization who requests money to attach the documents below along with this application:
1) The Budget for the year
2) The Profit and Loss Statement
3) The Balance Sheet

Salaries for top two individuals/employees:
($ amount in USD)
($ amount in USD)
How many years has your charitable organization been functioning? Please provide the following information:
(note that a new funding year begins every September 1st)

Funding Request

($ amount in USD)
(note that the Foundation can not provide funds for direct operating overhead)

Requestor's Contact Information

Supporting Files

We need every organization who requests money to attach the documents below along with this application:
1) The Budget for the year
2) The Profit and Loss Statement
3) The Balance Sheet

We welcome any additional information about your organization. Please feel free to attach it below.

*Alternatively, you may send an email with your documents attached to: BillieJo Peterson at swansonbi@mosaictelecom.net

Drop a file here or click to upload Choose File
Maximum upload size: 2.1MB
Drop a file here or click to upload Choose File
Maximum upload size: 2.1MB
Drop a file here or click to upload Choose File
Maximum upload size: 2.1MB
Drop a file here or click to upload Choose File
Maximum upload size: 2.1MB

(help us avoid SPAM form submissions by checking or answering the above)

Review & Submit

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