Application Organization Information Organization Mission Statement* Highlight the organization's mission statement Character Limit: 500 IRS Regulations* Is the organization in compliance with IRS regulations to remain a 501(c)3 and either a 509(a)1 or 509(a)2 organization? (Please note does not award grants to 509(a)3 organizations) If other IRS status please explain below Character Limit: 150 Prior Requests* Has the organization previously requested funding from? Prior Funding* Has the organization previously received funding from? Please note: All previous grant recipients are required to wait one year after receiving funds to reapply. All multi-year grant recipients must wait until they receive their final award payment prior to reapplying. Project Information Project Name* State the project title Printed On: 30 June 2016 Application 1
Character Limit: 250 What is the purpose of the request?* Provide a brief description of the project Character Limit: 250 Project Benefit Describe the impact the proposed project will have on the constituency served Character Limit: 1500 Amount Requested from * Amount already secured for project* Total cost of the project* Partial Funding* often can only partially fund a project. Will the organization implement the proposed project with partial funding from? Project Area* Select the category(s) that best describes the proposed project's focus Affordable Housing Arts & Culture Civil Services Community Enrichment Economic Development Education Employment Environment Family Services Health Human Services Innovation Military Support Religious Services Printed On: 30 June 2016 Application 2
Senior Services Sports Women Youth State the anticipated time frame for the project Include project start and end date Character Limit: 100 How many people will be impacted by the proposed project? Character Limit: 6 Population Served* Select the category(s) that best describes the population that will be served by the proposed project Disaster Victims General Population Homeless Low-Moderate Income People with Disabilities Seniors Underserved Veterans Youth Geographic Scope of Project* Select the area(s) that will be served by the proposed project New Jersey - Atlantic County New Jersey - Bergen County New Jersey - Burlington County New Jersey - Camden County New Jersey - Cape May County New Jersey - Cumberland County New Jersey - Essex County New Jersey - Gloucester County New Jersey - Hudson County New Jersey - Hunterdon County New Jersey - Mercer County New Jersey - Middlesex County Printed On: 30 June 2016 Application 3
New Jersey - Monmouth County New Jersey - Morris County New Jersey - Ocean County New Jersey - Passaic County New Jersey - Salem County New Jersey - Somerset County New Jersey - Sussex County New Jersey - Union County New Jersey - Warren County New York - Nassau County New York - Rockland County New York - Suffolk County New York - Westchester County New York City - Bronx Borough New York City - Brooklyn Borough New York City - Manhattan Borough New York City - Queens Borough New York City - Staten Island Borough New Jersey - Statewide New York City & Long Island Relationship with Investors How did you first learn about?* Do you have contact with an Investors Bank branch or employee? Are any bank employees affiliated with your organization (ie: board member or volunteer)? List the employee(s) name and relationship with your organization Type NA if not applicable 0 Does the organization participate in Investors Bank's "Care2Share" program?* Document Uploads - All uploads must be in PDF format Project Budget* Upload a copy of the project budget (maximum 1 page) Printed On: 30 June 2016 Application 4
Organization Financials Upload a copy of the organization's most recent financial report File Size Limit: 7 MB Organization Board of Directors/Major Donors Upload a list of the organization's Board of Directors/Trustees and their business affiliations Major Donors Upload a list of the organization's major contributors Additional Information If you would like to include additional information such as letters of support, and photographs scan them into one document and upload (no more than 2 pages) File Size Limit: 5 MB Printed On: 30 June 2016 Application 5