Grant Distribution Request Form

As a fund representative of a Donor Advised fund, you may make a grant distribution request using this form. The Community Foundation's Executive Committee and/or Board of Trustees must approve all grants awarded from any fund.

Donor-advised fund distribution recommendations must be reviewed for up-to-date IRS charitable status by the Community Foundation before grant checks can be issued.  Our Donor Services Department will perform this due diligence and will notify the Donor if a potential grantee does not meet the required eligibility.

Distributions from donor advised funds may be awarded as grants to 501(c)(3) public charities or to quasi-governmental organizations and may not be used to pay pledges made by the Founding Donor, purchase tickets, pay participation fees, award funding for which the Founding Donor receives goods or services in return for the grant, or award grants to individuals. The minimum distribution is $250 per check.

Fields that are marked with an asterisk (*) are required. You will receive an email confirmation of your form submission.

Grant Distribution Request Form
Donor First Name :(*)
Please add a value for First Name.
Donor Last Name :(*)
Please add a value for Last Name.
Name of Fund:(*)
Please add a value for Name of Fund.
Donor Telephone Number :(*)
Please add a value for Donor Telephone Number :.
Donor Email :(*)
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Grantee Name/Payable to:(*)
Please add a value for Grantee Name/Payable to:
Grantee Mailing Address:(*)
Please add a value for Grantee Mailing Address
City:(*)
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State:(*)
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Zip:(*)
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Grant $ Amount Requested:(*)
Please add a value for Grant $ Amount Requested:
Is the grant to be restricted for a specific charitable purpose?(*)
Please add a value for Is the grant to be used for a specific charitable purpose?
(checking
(checking "no" assumes grantee may use funds as needed)
If yes, describe restricted charitable purpose:
Additional comments :
(*)
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