Application for Organization/Individual
Incomplete applications will automatically be denied assistance
APPLICATION & SUPPORTING DOCUMENTS MUST BE PRINTED AND LEGIBLE
Organization/Individual Information
- Legal Name of Organization/Individual
- Mailing Address:
- Telephone:
Fax:
- Name/Title of Person submitting application:
- Direct Phone #
________
Date of application
- Is your organization an IRS 501(c) (3) not-for-profit?
Yes
No
- How many athletes will be served through this funding? __________
- Have you ever received a grant from the Hardee Athletic Foundation?
Yes
No
___ If yes, date of grant:
(Attach copy of previous application and grant)
Request
- Amount of Request:
- Project Name:
- State purpose of Organization/Agency/Individual Request: (How funds will be used?)_______________
________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
List individually other funding sources for this request. Include amounts and whether received, committed, or
projected/pending:
Source #1
Amount
Status
Source #2
Amount
Status
Source # 3
Amount
Status
- The following MUST accompany this application: (All documentation must be printed and legible)
-
Organization’s Mission Statement or Statement of Purpose
Project Description (Specific – 1 page maximum)
Project Goals and Objectives (Specific – 1 page maximum)
Explanation of how the funds will be used (include cost estimates for contract work, equipment, camp receipts, etc)
IRS 501(c)(3) documentation – if applicable
List of Board of Directors (include addresses & phone numbers)
Budget & cash flow statements (if requested) for the current year
List of current funding sources
The information contained in this statement is for the purpose of obtaining funding from the Hardee Athletic Foundation, Inc.
on behalf of the undersigned. Each undersigned understands that the information provided herein is used to consider the
request for funding, and each undersigned represents and warrants that the information provided is true and complete and
that the Hardee Athletic Foundation, Inc. may consider this statement as continuing to be true and correct until a written
notice of a change is provided. The Hardee Athletic Foundation, Inc. is authorized to make all inquiries they deem necessary
to verify the accuracy of the statements made herein.
Name of Organization /Individual
Submit original and (6) copies of
completed application & related documents to:
____________________________________
Signature of Individual
Hardee Athletic Foundation
Attn: Grant Application
PO Box 1743
Wauchula, FL 33873
Representative/Parent Signature
Signature of Authorized Officer
Date
Incomplete applications will automatically be denied assistance
For HAF Use Only
Application Qualifying Checklist

All requested material provided

Supplemental Funding or Special Exception

Amount Requested _______________

Amount Provided________________
Signatures
______________________
(Officer)
____________
(Date)
______________________ ______________
(Board Member)
(Date)