Mini Grant Application

Mini-Grants: $1,000 or less

Complete this form to submit your Mini-Grant request, any time of year. Be sure to provide all the requested information. Notification of award takes approximately two weeks.

Questions? Contact the Program Officer at (607) 734-6412, or by

Agency Name *:

Agency Phone *:

Fax:

EIN #:

Website:

Contact Person

Name / Title *:

E-Mail *:

Phone *:

Program Name *:

Amount Requested *:

Check should be made payable to *:

Mailing Address for Payment *:

Program Description *:

Project Budget: PROJECT INCOME

List each actual and/or anticipated source of funding for this project ONLY.

Project Budget: PROJECT EXPENSES

List expenses for this project.

Expense Item	Amount	Amount of item to be funded by Foundation grant













Total Project Expenses	$	$

The Community Foundation of
Elmira-Corning and the Finger Lakes, Inc
301 South Main Street
Horseheads, NY 14845
Tel: 607-739-3900
Fax: 607-739-3971

Funding Source	Amount	Funds Requested	Funds Committed







Total Project Income	$