Global Grant Application

Organizational Information

Existing Contact

Organization Name*

Legal Name

Address*

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

Phone*

Email*

Website*

Facebook Account

Twitter Account

Organizational Contact Person

Name*

First Last

Phone*

Email*

Job Title*

File

Financial-Grant Information

Date of Incorporation*

Total organization budget for current year*

Grant Amount requested from FBT*

How will requested funds be used?*

Program/project title for the Grant Requested*

FBT Grant Requirements

Is your organization tax exempt in your country of operation?*

Yes
No

If no, please explain further*

Is your organization authorized to accept foreign funds (american dollars) in your country of work? Example FCRA authorization in India, etc.*

Yes
No

If no, please explain further.*

Is your organization involved with or support political activities?*

Yes
No

If yes, please explain further.*

Has your organization, your current or past staff, your current or past Board of Directors or volunteers ever been involved in a law suit, conviction or financial misdemeanor?

Yes
No

If yes, please explain further.*

Please attach audited financial statements for the last program year or budget for upcoming year.

Drop files here or

Please attached By-Laws, List of Board of Directors, Organization mission, vision & values and/or other relevant legal documentation, as needed.

Drop files here or

Can the project grant funds be provided over a period of one-to-two years?*

Yes
No

If no, please explain further.*

Does your organization receive funding from another organization or foundation like FBT?*

Yes
No

If no, please explain further.*

FBT provides financial support to reimburse vendors. Can your organization identify vendors to pay this grant money?*

Yes
No

If no, please explain further.*

Please provide additional information reading your staff. # Employees and Total Salary/Personnel Expense.*

Please share any additional information that would assist FBT in making the grant decision. Past major achievements, individuals/organizations who can serve as reference, measures of success for this grant request, etc.*