Request for Funds Form

The Eagle & Badge Foundation Board of Directors meets every 4-6 weeks and will review all Requests at that time. The applicant will be advised of the Board’s decision within one week thereafter. The Foundation ‘s funding guidelines can be found on the Eagle & Badge website www.eagleandbadgefoundation.org. It is understood that the Foundation is not able to fund every request, due both to the Foundation’s charitable giving guidelines and the availability of funds at the time of the request.

INDIVIDUAL

NON-PROFIT ORGANIZATION

OTHER

URGENT:

If this Request is time sensitive and requires urgent processing, please check here.

Applicant or Contact Name

First Name

Last Name

Tel (H/O)

(###)

###

####

Organization Name (if applicable)

Tax ID #

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mobile

(###)

###

####

Fax

(###)

###

####

Website

http://

Date

YYYY

Purpose of the Organization/ Purpose of the Request

If requestor is an organization, briefly outline the purpose of the organization and attach a brochure OR one page fact sheet on the organization, including details as to mission statement, how the organization is usually funded, how funds are dedicated, areas served, recent accomplishments, copy of 501 (c) 3 paperwork, etc. If an individual, please list the purpose of the request.

Amount Requested: $

Have you received funds from this foundation previously?

If this request is granted, how will these funds be used (program expenses, administrative,? )

How did you hear about the Foundation?

Referred by

LAPD Serial #

Phone

(###)

###

####

Eagle & Badge Foundation

1308 West 8th Street Los Angeles, CA 90017 We understand that this request will be submitted to the Eagle & Badge Foundation Board of Directors; that all requests will be given equal consideration, subject to the end use falling within approved bylaws and guidelines of the organizations’ charter; that completion of this application does not guarantee approval of funds; and that the amount of funding may vary from what is requested;

Request for Funds Form

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