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Samuel Staten, Sr. Charitable Trust Grant Application

Introduction

Thank you for your interest in applying for funding from the Samuel Staten, Sr. Charitable Trust. To ensure a thorough and equitable review of all requests, we require a completed grant application. We appreciate your time and dedication to serving the community and look forward to reviewing your request.

Important Notes:

• As a charitable trust, we do not fund any program or nonprofit in its entirety. Our goal is to distribute funds equitably across the community to maximize our impact.
• Incomplete applications may delay the review process or result in non-consideration.

To Apply:

• Download and complete out the Grant Application Form (click here)
• Submit the complieted application form to: StatenCharitable@gmail.com
• Note: Grant applications are accepted on a rolling basis.

The Grant Application form will require you to provide the following information:

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I. Organization Information

1. Organization Name:
2. Tax ID (EIN) Number:
3. Mailing Address:
4. Website and Social Media Links:
5. Primary Contact Name, Title, Email, and Phone Number:
6. Organization’s Mission Statement:
7. 501(c)(3) Status Verification: (Attach IRS determination letter or equivalent for nonprofit status.)
8. Brief History of Organization & Key Achievements (250 words max):

II. Funding Request Details

1. Program/Project Title:
2. Amount Requested:
3. Total Program/Project Budget: (Attach a detailed budget breakdown.)
4. Describe the Purpose of the Grant (500 words max):
   • What issue does this program/project address?
   • How will the funds be used?
   • Who will benefit from this funding? (Include estimated number of individuals impacted.)
5. List of Key Program Staff & Their Roles (if applicable):

III. Financial & Fundraising Information

1. Total Annual Operating Budget of Organization:
2. List of Current and Past Funders (Past Fiscal Year):
3. Percentage of the Total Program/Project Budget Covered by Other Funders:
4. Other Funding Sources for This Program/Project (Pending or Confirmed):
5. Have You Received Previous Funding From the Samuel Staten, Sr. Charitable Trust? (Yes/No)
   • If Yes, please attach a report detailing how previous funds were used.

IV. Impact & Recognition

1. Expected Outcomes & Impact:
   • How will you measure success?
   • What are the expected short-term and long-term outcomes?
2. How Will You Recognize Our Support? (Check all that apply):
   • ☐ Press Release
   • ☐ Website & Social Media Acknowledgment
   • ☐ Event Sponsorship Recognition
   • ☐ Check Presentation Opportunity
   • ☐ Other (please describe): _____________

V. Required Attachments

• ☐ 501(c)(3) Determination Letter (if applicable)
• ☐ Detailed Program/Project Budget
• ☐ Most Recent Annual Report or Financial Statement
• ☐ Report on Previous Funding (if applicable)

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Submission Instructions:

• Submit all required materials via email to: StatenCharitable@gmail.com .
• Incomplete applications will not be considered.
• Grant applications are accepted on a rolling basis.

Click here to download the application form.

Since 1999, the Samuel Staten, Sr. Charitable Trust has raised over $3.4 million for local charities, showcasing the positive impact of organized labor in our community!