Grant Request Form

Giving Youth the Tools They Need to Grow Their Best

Roessner Family Foundation
P.O. Box 234, Harwich Port, MA 02646

General:

Organization Overview:

Does the organization’s mission align with the RFF mission?

Statement of Need (Proposal):

What is the requested amount?
Name of Program/s or Need?
In 1-2 sentences only, please summarize this program/need:
If you have received a grant in the past from RFF, is this request the “Same Request” or “Different Request”?
What is the age range of children the program/need will serve?
Please select the RFF Program Area
Academic
Social/Emotional/Physical
Learning Disabilities
Special Needs
Leadership Development
Other Wellbeing Programs
Please Select the Target Population (Youth Served) of Request
At risk
Low income
Underserved
Foster care
Physical challenges
Illness
Special needs
Learning disabilities
Children with social, emotional challenges
Trauma healing
All youth
Other
Is the need for grant request time sensitive? If yes, please explain.

Description, Detail and Impact of Program/Need:

Financial & Structure:

(please click here to email Program/Need Budget, Organizational Budget, 501(c) 3 IRS Determination Letter, 990 or most recently audited financials)

Have you have received a grant from the RFF in the past?:

Please enter the text in the box below: