HIF Grant Form for Grantees

I certify that the information I give on the application is complete and correct. I understand my failure to provide complete, accurate and truthful information on the application will be grounds to deny my application. I hereby agree to allow HIF to send information on the status of my application and other grant opportunities to the contact information I provide.

Terms and Conditions*

I accept the above terms and conditions to continue

I. ORGANIZATION

Organization name:*

Established:*

Address:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Web Page Address:

Additional web links (e.g. social media pages):

Chief Executive Officer:*

First Name Last Name

Primary Contact:*

First Name Last Name

Primary contact title:*

Primary contact daytime phone Nr:*

Primary contact email:*

Enter Email Confirm Email

Organization's mission, main activities:*

Organization’s Annual Operating Budget:*

II. TAX STATUS:

Legal Name (if different from Org. Name):

EIN:*

TIN:*

As of:*

Is the organization a 501(c)3? Yes/No*

YES
NO

III. PROJECT INFORMATION:

Project or Program Short Title:*

Total Budget:*

Grant amount:*

Percentage of total project budget:

List your expected sources of funding (other than HIF) with expected amount:

Project term – time frame for which project funding is requested:

Start Date:*

End Date:*

IV. EXECUTIVE SUMMARY

Detailed description of the project:*

Detailed work phases with specific timeline:*

How you will measure success?*

How will you solicit feedback from participants?*

List the partners, key people and organizational allies you plan to involve (both in Hungary and in the US):

Who is your target audience, what is your expected reach?*

Planned communication of the project including expected media coverage:*

How will you involve HIF in the planning and execution of the project? Please be as specific as possible.

VI. REQUIRED ATTACHMENTS

1. Cover Letter from the Chief Executive Officer to include: brief description of request and project, request amount, and certification statement that the 501(c)3 tax exemption ruling is still correct and that no modifications are planned or pending.

Upload Grant Request Cover Letter:*

Accepted file types: pdf, Max. file size: 128 MB.

2. 501(c)3 tax exemption ruling letter from the United States Internal Revenue Service (IRS) for the current legal name. If tax exempt under a group ruling for a central organization, also attach the latest certificate of membership.

Upload 501(c)3 tax document: (if applicable)

Accepted file types: pdf, Max. file size: 128 MB.

3. Most recent year’s financial statements

Upload financial statements:*

Accepted file types: pdf, Max. file size: 128 MB.

4. Total project budget, the amount of funds requested from the Foundation and a line-item expense and revenue budget showing all projected sources of funds for the program/project over the proposed grant period. (Please use excel format attachments)

Detailed Project Budget:*

Accepted file types: xls, xlsx, Max. file size: 128 MB.

HIF Grant Form - 2019

I. ORGANIZATION

II. TAX STATUS:

III. PROJECT INFORMATION:

IV. EXECUTIVE SUMMARY

VI. REQUIRED ATTACHMENTS

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