The Wilber L. Burress Endowment Grant Application - The Arc of The Quad Cities Area

Name*
First Last
Department*
Phone*
Email*
Start Date*
Anticipated date of initiation of the project
MM
DD
YYYY
Amount Requested*
Has the Burress Endowment funded this project in prior years?*
Project Title*
Project Description*
Category*
- Select All
- Activities
- Equipment
- Program
- Capital
- Other
If Other, please explain
Project Objective(s):*
How does this proposal further the mission and/or priorities of the Arc?*
Number of individuals who will DIRECTLY benefit from the project*
Number of individuals who will INDIRECTLY benefit from the project*
Will the project still be viable if an amount lesser than requested is awarded?*
Do you know of any other sources of funding for your proposal? Please state:*
Budget Form
Detail Your Budget*
Please describe items and give amounts. Use the plus sign (+) to add more fields.
Item Description Total $
Total Cost*
Please sum the line items above

Item Description	Total $

Budget Form