Preliminary Grant Application To apply for funds from the Colonel Robert H. Morse Foundation, use the form below to provide the preliminary required information. Please note that the form below only represents a portion of the required information. Someone from our office will contact you if your preliminary application qualifies for further consideration. In the meantime, you may review the other required documents for the final application. Date submitted    Organization name Address 1 Address 2 City, state, zip    Chairperson of the governing body Contact person Contact person's title Contact person's telephone ()   Contact person's email Amount requested $ Duration of the project from:  (month/year) to:  (month/year) Total project budget $ When are funds needed? Agency Information Date established    Number of full-time employees General description of organization and purpose, with an indication of population served (including numerical estimates for the last year) and principal geographic area of service What are the dates of organization's fiscal year? from:  (month/day) to:  (month/day) Total operating expenses for last fiscal year? $  Total operating expenses for current year? $  Has the governing board approved a policy which states that the organization does not discriminate as to age, race, religion, sex, or national origin?  yes  no Does the organization have FEDERAL tax-exempt status?  yes  no If no, please explain. Has this request been authorized by the organization's governing body?  yes  no When?

Colonel Robert H. Morse Foundation, P.O. Box 238, Beloit, WI 53512-0238