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The Dana Home Foundation Program Grant Application Part 1

  • Gather the information requested below.
  • Save the information (including questions) in a .pdf format.
  • Go to Grant Application Part 2.
Applicant and Program Information
  1. Organization’s Name          
  2. Program Name        
  3. Grant Amount Requested  
  4. Total Budget for Program
  5. Brief Summary of Program
  6. Does organization have IRS 501(c)(3) status? (if so, skip to question 8)
  7. Is applicant a municipal or other US governmental entity intending to use the funds solely for charitable purposes?
  8. Were previous grants received from The Dana Home Foundation within the last five years? 
  9. Primary contact name (person able to answer questions and/or provide additional information about Part I of the Grant Application.)
  10. Primary contact email address
  11. Primary contact telephone
  12. Describe anticipated program timeline including anticipated program starting date and program completion date, if applicable
  13. Provide a detailed one-page summary of the proposed program’s total budget that includes:
    a.   An itemized list of projected expenses; and
    b.   All sources of funding for this program (and the amount anticipated from each source).
  14. If you anticipate this program continuing beyond this grant year, please specify how you plan to continue funding the program.
  15. Describe program funding and success in previous years. (If this is a new program, state so.)
  16. State program goals and objectives and describe your plan to meet these goals and objectives.
  17. Describe your plan to measure your achievement of program goals.
  18. Describe the target audience of the program.
  19. Provide anticipated number of seniors served by program and describe the seniors’ connection to Lexington.
  20. List any other organizations/departments you are collaborating with to accomplish the program.
  21. Describe any additional approvals needed for program. 

The Dana Home Foundation
P.O. Box 189
Lexington, MA 02420

danahomefoundation@gmail.com
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