Global Grant Application Global Grant Application Organizational InformationExisting ContactOrganization Name*Legal NameAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Phone*Email* Website* Facebook AccountTwitter AccountOrganizational Contact PersonName* First Last Phone*Email* Job Title*FileFinancial-Grant InformationDate of Incorporation* Total organization budget for current year*Grant Amount requested from FBT*How will requested funds be used?*Income Generation SolutionWomen Empowerment SolutionYouth Development SolutionHealthcare SolutionEconomic Development SolutionProgram/project title for the Grant Requested*FBT Grant RequirementsIs your organization tax exempt in your country of operation?*YesNoIf 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.*YesNoIf no, please explain further.*Is your organization involved with or support political activities?*YesNoIf 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?YesNoIf 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?*YesNoIf no, please explain further.*Does your organization receive funding from another organization or foundation like FBT?*YesNoIf no, please explain further.*FBT provides financial support to reimburse vendors. Can your organization identify vendors to pay this grant money?*YesNoIf 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.*
