Grant Program Application

A Heart for Horses Inc.(AH4H) Montana Horse Community Grant Application

Please review the grant application guidelines prior to completing this document.

Name of grant project*
Amount requested*
Please enter a number from 100 to 1000.
Proposed Start Date of Project*
Date Format: MM slash DD slash YYYY
Proposed Date of Completion*
Date Format: MM slash DD slash YYYY
Has the Applicant/Organization ever applied for a AH4H Montana Horse Community Grant?*
- Yes
- No
If the applicant has previously received a AH4H grant what year(s) did it receive them?
Name of Applicant/Organization*
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Website
Federal Tax I.D. number (EIN)
(If you do not have a federal Tax I.D. (EIN) thats Ok, the grantee must provide IRS form W9 at time of funds granted)
Contact Person*
First Last
Address (if different from above)
Street Address Address Line 2 City State ZIP Code
Phone (if different from above)
Email (if different from above)
Brief biography of contact person*
(maximum 150 words)
Brief history of the organization*
(maximum 150 words)
Explain how the grant money will be used in the project*
(maximum 150 words)
Check the box(es) that best describe(s) the goals of your project*
- Youth Activity/Education
- Equine Rescue/Rehabilitation
- Facility Development
- Horse Health Awareness
- Therapeutic Equine Activity
(maximum of 3 boxes)
Summarize how your project will further one or more of the above goals*
(maximum 150 words)
Who will benefit from this project?*
(25 words or less)
In what Montana county is the applicant/organization based?*
Attach a brief breakdown of how grant funds will be used*
Accepted file types: doc, docx, gif, jpg, png, pdf, xls, xlsx.
List expenses specifically related to the project and the cost of each expense. (ex: booth or print materials - $1,000; fee for judge/clinician/announcer - $400, etc.)
Will you have other funding sources or matching funds for this project, or donation of in- kind goods or services?*
- Yes
- No
If yes, please describe, including amount or dollar value of matching funds (100 words or less)*
Please list any project collaborators
Name
First Last
Organization (if applicable)
Role in Project
Address
Street Address Address Line 2 City State ZIP Code
Phone
Fax
Email
How will your organization acknowledge this grant to its membership and/or the general public?*
Name to make check payable to*
Address to mail check to (if not presented)
Street Address Address Line 2 City State ZIP Code
Signature of Authorized Agent for Organization*
Printed Name*
Title of Authorized Agent for Organization*
Date Signed: 03/28/2023
Name
This field is for validation purposes and should be left unchanged.

Grant Program Application

Please list any project collaborators