2023 Kids' Chance National Conference in Indy

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2023 Emergency Grant
Application

Please complete and return this application by November 1, 2023. If you have
any questions, please contact us at admin@kidschance.org.

Date of Application*

State Organization*

Contact Person Name*

Contact Person Title*

Email*

Phone*

Invalid number

✅

Address*

Requested Amount ($)*

(Note: Funds must be used in the 2023-2024 scholarship year)

Current Fiscal Year Operating Budget ($)*

Upload Form 990

Upload File

Max file size 10MB.

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Number of Scholarships Awarded for the Past Academic Year*

Total Amount of Funds Allocated for the Past Academic Year ($)*

Average Scholarship Award ($)*

Please provide a list of recipients with contact info, grant amount, educational institution, and amount of unmet need.*

Upload File

Max file size 10MB.

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What circumstances (unusual or unforeseen) precipitated your request for Emergency Grant funds?*

Has your organization had a recent increase in qualified applicants?*

YesNo

If yes, please explain

Has your organization had a recent decrease in revenues?*

YesNo

If yes, please explain

Are you fulfilling the unmet needs of your scholarship applicants?*

YesNo

If yes, please explain

Does your organization maintain a financial reserve for rainy days or endowment funds?*

YesNo

If yes, what is the present balance in this fund? ($)

Have you received emergency grant funds in the past?*

YesNo

If yes, how much were you awarded?

Please provide any additional information which will support your request for the receipt of an Emergency Grant from Kids' Chance of America.

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You've submitted your application successfully. If you have any questions, please reach out to admin@kidschance.org.

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