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Community Giving Application

Contact Information Fields are required

Funding Information

Is the organization a tax-exempt nonprofit? Select One Yes No  

Is the organization requesting a challenge grant? Select One Yes No  

Is the organization Vermont-based? Select One Yes No  

Will there be an opportunity for public acknowledgement or other benefits to CVPS if a grant is approved? Select One Yes No  

If so, describe the nature of the proposed
acknowledgement or benefits.

Is the organization funded by the United Way? Select One Yes No  

If so, state the most recent United Way award amount and date below.

Amount: $

Date: 

Does the application fall into one of the following categories? Check each one that applies.

Environment
Community & Economic Development
Health, Wellness & Safety
Children & Youth Development
Other

Please describe below how this grant would be used, the goals of the project or program and how the success of the project will be determined.

Security Code:

Attach File: