Nonprofit Grant Request Form
Name of Applicant Organization:
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(As it appears on your organization's deposit slip)
Type of Organization:
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(e.g. Charitable Trust, Non Profit body, Sports club, etc.)
501 C 3?
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Yes
No
EIN#:
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What is the purpose or goal of your organization:
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Physical Address:
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Mailing Address:
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E-mail:
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Website:
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Contact Person:
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Phone Number:
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What connection do you have with a Delta pilot?
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If yes, what is the Delta pilot's name:
Will your charity benefit a Delta hub or a Delta community?
If so please indicate the appropriate hub.
ATL
CVG
DTW
LAX
MSP
NYC
SEA
SLC
All donations must be used for children in need 18 years of age and younger. Will This requirement be met with your request?
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Yes
No
Has this organization ever applied for a grant from the Delta Pilots Charitable Fund? Eligibility is limited to once every three years.
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Yes
No
If yes, when?
Was this organization approved for a grant from the Delta Pilots Charitable Fund in the past?
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Yes
No
If yes, when?
If yes, How much?
Current $ Amount Requested
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Specifically what is the money requested to be used for?
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(Please explain in detail. If you do not have enough space please attach a letter or any documentation that you feel will be helpful. You must specify in detail what the money will be used for.)
Is there a deadline you are trying to meet?
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What percentage of money received is used for contributions, gifts and grants?
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Please attach the following documentation if applicable:
*** Incomplete applications will not be considered.
Board Members
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Audited Financials
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Key Staff
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Any information that will help us understand the mission and goals of your organization.
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