Application for Non-Profit Assistance

Based on Christian principles, the Trideum Foundation seeks to provide a help and a hope in and through local communities by funding charitable projects that provide a catalyst for volunteer participation.

Instructions: Please complete the following application in full. Incomplete applications will not be considered. Please be sure to attach any brochures or advertisements pertinent to this project for your group or organization.

Applicant Information

Name:

Applicant Information

First Name

Last Name

Phone:

Applicant Information

(###)

###

####

Address:

Applicant Information

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email:

Applicant Information

Recipient Information

Organization Name:

Recipient Information

Phone:

Recipient Information

(###)

###

####

Point of Contact:

Recipient Information

First Name

Last Name

Address:

Recipient Information

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email:

Recipient Information

Website:

Recipient Information

http://

Is the Group / Organization tax exempt under IRS 501(c)(3)?

Yes

Federal Tax ID (EIN):

Recipient Information

Describe the type of group or organization & their activities:

Recipient Information

Optional Reference #1

IF assistance is direct to an individual, list below personal references for the individual who know the circumstances of the request:

First Name

Last Name

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Optional Reference #2

IF assistance is direct to an individual, list below personal references for the individual who know the circumstances of the request:

First Name

Last Name

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Detailed Request Information

List any other assistance requested for this situation from other groups or organizations and contacts, if any

List any known relationships of the recipient to any Officers, Directors or major contributors of the Trideum Foundation

Describe in detail the funding assistance requested, including proposed projects, who will benefit from the projects and what outcomes are expected

How do the principles outlined in Trideum Foundation's purpose (“to provide a help and a hope in and through local communities by funding charitable projects that provide a catalyst for volunteerism”) fit this request?

Project funding plan if funding is awarded from the Trideum Foundation. Include the amount you are requesting and how you would spend the funding.

Please describe the timeline for this request. Include any significant need dates that may be pertinent to the approval process.

How were you referred to the Trideum Foundation?

Note: If you receive funding assistance, you may be asked to provide receipts, invoices, and/or other related documentation.