X/TwitterThis field is for validation purposes and should be left unchanged.Name of Organization or Charity(Required)Organization or Charity Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Contact Person(Required) First Last Title(Required)Phone(Required)Cell PhoneEmail(Required) Organization's Mission Statement(Required)List of organization's board of directors, including name and position(Required)NamePosition Add RemoveAmount requested(Required)Would you accept partial funding?(Required)YesNo Required Documentation for Application Please upload the required documentation for application:IRS Exemption Determination Letter (501(c)(3) exemption)(Required)Max. file size: 10 GB. Most Recent Annual Budget(Required)Max. file size: 10 GB. IRS Form 990 (previous 2 years)(Required) Drop files here or Select files Max. file size: 98 GB, Max. files: 2. W9(Required)Max. file size: 10 GB. Project narrative to include: How many individuals, families, or groups will this grant serve in Union, Stanly, Cabarrus, Mecklenburg, or Rowan counties? Amount requested Specific use of requested funds. Please give details. Are you receiving any other funding for the specific use described above? How does your organization measure the effectiveness of its programs? Project Narrative(Required)Max. file size: 10 GB. Applicant SignatureDisclaimer: The information contained in this application is for the sole purpose of obtaining funding from Union Power Charitable Foundation. I understand that the information provided will be used to decide whether or not to fund the grant requested. The information in this application is true and complete. I hereby verify the information to be true and complete and agree to the terms and conditions. I understand that by typing my full name and pressing the Submit button, this form submission will be stamped with today’s date and authorized by me as if I had signed my signature.Application Signature (Full Name)
